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General NPI Number Information
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NPI Number | 1497121917
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Entity Type | Organization
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Legal Business Name | BSJ PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 03/13/2016
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Provider Practice Location Address
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Address Line | 150 BROADHOLLOW RD #316
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City | MELVILLE
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State | NY
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Zip | 11747-4905
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Country | US
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Telephone | 516-408-0990
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Fax |
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Provider Business Mailing Address
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Address Line | 150 BROADHOLLOW RD #316
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City | MELVILLE
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State | NY
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Zip | 11747-4905
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Country | US
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Telephone | 516-408-0990
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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 | MR. 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 | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 032544
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License Number State | NY
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