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General NPI Number Information
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NPI Number | 1174343313
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Entity Type | Organization
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Legal Business Name | INSPIRE CORE PT PLLC
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 418 BROADWAY STE N
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City | ALBANY
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State | NY
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Zip | 12207-2922
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Country | US
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Telephone | 646-209-8764
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Fax |
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Provider Business Mailing Address
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Address Line | 4131 219TH ST FL 1
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City | BAYSIDE
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State | NY
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Zip | 11361-3541
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Country | US
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Telephone | 646-209-8764
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | JONATHAN YIP SHING LAM
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Credential |
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Telephone | 646-209-8764
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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 |
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License Number State |
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