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NPI Code Detail

MEDICARE: YOUNGSU NA PHYSICAL THERAPY PC

MEDICARE: YOUNGSU NA PHYSICAL THERAPY PC
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

General Provider Information

NPI Number : 1548973092
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOUNGSU NA PHYSICAL THERAPY PC
Provider Business Mailing Address
First Line : 6700 192ND ST APT 508
Second Line :
City : FRESH MEADOWS
State : NY
Zip : 11365-3778
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 42 BROADWAY STE 1219
Second Line :
City : NEW YORK
State : NY
Zip : 10004-3834
Country : US
Telephone Number : 718-886-3531
Fax Number :
Authorized Official
Title or Position : PT/PRESIDENT
Name : YOUNGSU NA
Credential : PT
Telephone Number : 929-496-5433
Provider Enumeration Date : 12/29/2022
Last Update Date : 06/08/2023

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Directions to “YOUNGSU NA PHYSICAL THERAPY PC ” Practice Location

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