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NPI Code Detail

MEDICARE: J LEE PHYSICAL THERAPY P.C

MEDICARE: J LEE 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
1225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11528671146OTHERNYNPI

General Provider Information

NPI Number : 1528671146
Entity Type Code : Organization
Provider Name (Legal Business Name) : J LEE PHYSICAL THERAPY P.C
Provider Business Mailing Address
First Line : 16410 NORTHERN BLVD STE 201
Second Line :
City : FLUSHING
State : NY
Zip : 11358-2668
Country : US
Telephone Number : 718-463-6700
Fax Number : 718-463-6174
Provider Business Practice Location Address
First Line : 16410 NORTHERN BLVD STE 201
Second Line :
City : FLUSHING
State : NY
Zip : 11358-2668
Country : US
Telephone Number : 718-463-6700
Fax Number : 718-463-6174
Authorized Official
Title or Position : PRESIDENT
Name : JAEKWAN LEE
Credential :
Telephone Number : 718-463-6700
Provider Enumeration Date : 08/24/2020
Last Update Date : 02/01/2023

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