Provider Demographics
NPI:1457059859
Name:GRIT WELLNESS REHABILITATION PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:GRIT WELLNESS REHABILITATION PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEONJOONG
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:201-815-3969
Mailing Address - Street 1:13338 41ST RD STE CS8
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3662
Mailing Address - Country:US
Mailing Address - Phone:201-815-3969
Mailing Address - Fax:
Practice Address - Street 1:13338 41ST RD STE CS8
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3662
Practice Address - Country:US
Practice Address - Phone:201-815-3969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy