=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164371332
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KM PHYSICAL THERAPY & ACUPUNCTURE PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2026
-----------------------------------------------------
Last Update Date | 02/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3625 PARSONS BLVD UNIT L1&2
-----------------------------------------------------
City | FLUSHING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11354-5938
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-353-7575
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3625 PARSONS BLVD UNIT L1&2
-----------------------------------------------------
City | FLUSHING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11354-5938
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LAC/PRESIDENT
-----------------------------------------------------
Name | KI TAE MAENG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 718-353-7575
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------