Provider Demographics
NPI:1881309938
Name:GRAPHENE PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:GRAPHENE PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-588-0082
Mailing Address - Street 1:39 BROADWAY RM 630
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-3075
Mailing Address - Country:US
Mailing Address - Phone:646-588-0082
Mailing Address - Fax:347-644-2747
Practice Address - Street 1:39 BROADWAY RM 630
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-3075
Practice Address - Country:US
Practice Address - Phone:646-588-0082
Practice Address - Fax:347-644-2747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy