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General NPI Number Information
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NPI Number | 1457064784
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Entity Type | Organization
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Legal Business Name | GOGO PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 01/02/2023
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Last Update Date | 01/02/2023
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Provider Practice Location Address
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Address Line | 2426 EASTCHESTER RD STE 204
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City | BRONX
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State | NY
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Zip | 10469-5950
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Country | US
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Telephone | 347-843-6230
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Fax |
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Provider Business Mailing Address
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Address Line | 109 CANDY LN
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City | SYOSSET
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State | NY
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Zip | 11791-4911
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Country | US
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Telephone | 718-757-8292
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEVIN KIM
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Credential | PT
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Telephone | 718-757-8292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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