Healthcare Provider Details

I. General information

NPI: 1679117881
Provider Name (Legal Business Name): FLUSHING PHYSICAL THERAPY, CHIROPRACTIC, & ACUPUNCTURE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2019
Last Update Date: 11/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15001 NORTHERN BLVD FL 1
FLUSHING NY
11354-3896
US

IV. Provider business mailing address

15001 NORTHERN BLVD FL 1
FLUSHING NY
11354-3896
US

V. Phone/Fax

Practice location:
  • Phone: 718-746-4919
  • Fax: 718-746-4920
Mailing address:
  • Phone: 718-746-4919
  • Fax: 718-746-4920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. SANGWOO MAH
Title or Position: MANAGING MEMBER
Credential: DC
Phone: 718-746-4919