Provider Demographics
NPI:1023489754
Name:YSJ PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:YSJ PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPT
Authorized Official - Prefix:
Authorized Official - First Name:SEUNG JO
Authorized Official - Middle Name:
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-733-2100
Mailing Address - Street 1:2430 DAVIDSON AVE
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-6364
Mailing Address - Country:US
Mailing Address - Phone:718-733-2100
Mailing Address - Fax:718-733-2400
Practice Address - Street 1:2430 DAVIDSON AVE
Practice Address - Street 2:FLOOR 2
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-6364
Practice Address - Country:US
Practice Address - Phone:718-733-2100
Practice Address - Fax:718-733-2400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-07
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty