1194969931 NPI number — BEST HANDS-ON PHYSICAL THERAPY PC

Table of content: (NPI 1194969931)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194969931 NPI number — BEST HANDS-ON PHYSICAL THERAPY PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEST HANDS-ON PHYSICAL THERAPY PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194969931
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6 KATHY PL
Provider Second Line Business Mailing Address:
3B
Provider Business Mailing Address City Name:
STATEN ISLAND
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10314-5926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-785-0520
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6 KATHY PL
Provider Second Line Business Practice Location Address:
3B
Provider Business Practice Location Address City Name:
STATEN ISLAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10314-5926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-240-8453
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/23/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
YOO
Authorized Official First Name:
SANG
Authorized Official Middle Name:
WON
Authorized Official Title or Position:
PHYSICAL THERAPIST
Authorized Official Telephone Number:
718-785-0520

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  025179 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A100026931 . This is a "MEDICARE PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 03251127 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: G100061602 . This is a "MEDICARE PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".