Healthcare Provider Details

I. General information

NPI: 1205411493
Provider Name (Legal Business Name): ROCK PHYSICAL THERAPY AND ACUPUNCTURE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2021
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 E 25TH ST STE 1
NEW YORK NY
10010-3103
US

IV. Provider business mailing address

229 E 28TH ST APT 6B
NEW YORK NY
10016-8562
US

V. Phone/Fax

Practice location:
  • Phone: 650-762-5692
  • Fax:
Mailing address:
  • Phone: 646-267-7285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PAUL Y LEE
Title or Position: OWNER
Credential:
Phone: 650-762-5692