Provider Demographics
NPI:1720612328
Name:SJ PHYSICAL THERAPY & ACUPUNCTURE PC
Entity Type:Organization
Organization Name:SJ PHYSICAL THERAPY & ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:DONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-565-4819
Mailing Address - Street 1:426 W 58TH ST PH 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1120
Mailing Address - Country:US
Mailing Address - Phone:848-565-4819
Mailing Address - Fax:646-559-1358
Practice Address - Street 1:426 W 58TH ST PH 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1120
Practice Address - Country:US
Practice Address - Phone:848-565-4819
Practice Address - Fax:646-559-1358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-24
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty