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General NPI Number Information
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NPI Number | 1033645254
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Entity Type | Organization
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Legal Business Name | 21 PHYSICAL THERAPY,P.C.
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Dates
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Enumeration Date | 05/08/2017
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Last Update Date | 05/08/2017
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Provider Practice Location Address
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Address Line | 27 W COLUMBIA ST
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City | HEMPSTEAD
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State | NY
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Zip | 11550-2429
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Country | US
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Telephone | 516-489-4666
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Fax | 516-479-0214
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Provider Business Mailing Address
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Address Line | 27 W COLUMBIA ST
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City | HEMPSTEAD
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State | NY
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Zip | 11550-2429
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Country | US
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Telephone | 516-489-4666
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Fax | 516-479-0214
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Authorized Official
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Title or Position | PROPRIETOR/PHYSICAL THERAPIST
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Name | SEONOGCHAN CHO
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Credential |
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Telephone | 347-610-5144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 027224
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License Number State | NY
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