Healthcare Provider Details

I. General information

NPI: 1154660074
Provider Name (Legal Business Name): ALL WELL PHYSICAL THERAPY AND ACUPUNCTURE P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2013
Last Update Date: 02/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9231 57TH AVE APT 5D
ELMHURST NY
11373-5062
US

IV. Provider business mailing address

9231 57TH AVE APT 5D
ELMHURST NY
11373-5062
US

V. Phone/Fax

Practice location:
  • Phone: 917-455-2172
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number024950
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: GANG ZHANG
Title or Position: PRESIDENT
Credential: PT
Phone: 917-455-2172