MEDICARE: YEONHWA PHYSICAL THERAPY, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1003776683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YEONHWA PHYSICAL THERAPY, P.C.

Provider Business Mailing Address
First Line	:	4354 196TH ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11358-3521
Country	:	US
Telephone Number	:	347-656-9672
Fax Number	:

Provider Business Practice Location Address
First Line	:	4354 196TH ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11358-3521
Country	:	US
Telephone Number	:	347-656-9672
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YEONHWA JEONG
Credential	:	DPT
Telephone Number	:	347-656-9672

Provider Enumeration Date	:	11/14/2025
Last Update Date	:	11/14/2025

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