1497515621 NPI number — GRIT CORE PHYSICAL THERAPY P.C.

Table of content: MR. JEFFREY LYNN BAKER PTA (NPI 1215216452)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497515621 NPI number — GRIT CORE PHYSICAL THERAPY P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GRIT CORE PHYSICAL THERAPY P.C.
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:
1497515621
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/15/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
251 W 74TH ST APT 7A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10023-2140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-815-3969
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 E 55TH ST FRNT 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10022-4514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-815-3969
Provider Business Practice Location Address Fax Number:
917-634-8851
Provider Enumeration Date:
03/22/2024

Additional Information

Authorized Official

Authorized Official Last Name:
LEE
Authorized Official First Name:
SEONJOONG
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
201-815-3969

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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