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General NPI Number Information
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NPI Number | 1356092837
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Entity Type | Organization
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Legal Business Name | BODYFIRST PHYSICAL THERAPY P.C.
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Dates
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Enumeration Date | 01/16/2022
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Last Update Date | 01/16/2022
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Provider Practice Location Address
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Address Line | 535 BROADHOLLOW RD STE B12
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City | MELVILLE
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State | NY
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Zip | 11747-3701
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Country | US
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Telephone | 631-626-9299
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Fax | 631-693-3399
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Provider Business Mailing Address
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Address Line | 535 BROADHOLLOW RD STE B12
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City | MELVILLE
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State | NY
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Zip | 11747-3701
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Country | US
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Telephone | 631-626-9299
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Fax | 631-693-3399
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. SUNGJUN BAE
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Credential | DPT
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Telephone | 347-569-2107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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