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General NPI Number Information
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NPI Number | 1306652680
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Entity Type | Organization
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Legal Business Name | GREEN MOVEMENT PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 05/31/2025
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Provider Practice Location Address
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Address Line | 945 HUGUENOT AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-4312
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Country | US
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Telephone | 347-830-7274
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Fax |
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Provider Business Mailing Address
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Address Line | 114 SIGNS RD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3836
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Country | US
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Telephone | 320-262-6653
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DERREK YANG
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Credential | PT, DPT
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Telephone | 320-262-6653
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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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