Provider Demographics
NPI:1205473774
Name:NEW CORE PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:NEW CORE PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WOOYOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:BAE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-281-4400
Mailing Address - Street 1:4029 235TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1509
Mailing Address - Country:US
Mailing Address - Phone:718-359-1004
Mailing Address - Fax:718-281-4402
Practice Address - Street 1:4029 235TH ST FL 2
Practice Address - Street 2:
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11363-1509
Practice Address - Country:US
Practice Address - Phone:718-359-1004
Practice Address - Fax:718-281-4402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty