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General NPI Number Information
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NPI Number | 1619845575
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Entity Type | Organization
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Legal Business Name | THE ACTIVE JUNCTION PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 6155 JUNCTION BLVD APT 21R
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City | REGO PARK
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State | NY
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Zip | 11374-2868
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Country | US
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Telephone | 914-362-9532
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Fax |
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Provider Business Mailing Address
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Address Line | 6155 JUNCTION BLVD APT 21R
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City | REGO PARK
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State | NY
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Zip | 11374-2868
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Country | US
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Telephone | 914-362-9532
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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 | JANE ROCHELLE PAHANG
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Credential | PT, NCCPT-CPT
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Telephone | 914-362-9532
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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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