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General NPI Number Information
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NPI Number | 1659157709
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Entity Type | Organization
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Legal Business Name | EMERALD PHYSICAL THERAPY & ACUPUNCTURE PC
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Dates
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Enumeration Date | 09/05/2023
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 315 WALT WHITMAN RD STE 214
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-4112
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Country | US
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Telephone | 631-923-0334
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Fax | 631-923-0335
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Provider Business Mailing Address
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Address Line | 2227 76TH ST APT B2
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City | EAST ELMHURST
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State | NY
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Zip | 11370-1264
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Country | US
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Telephone | 631-923-0334
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Fax | 631-923-0335
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Authorized Official
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Title or Position | DPT & LAC/PRESIDENT
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Name | YU SHIN OH
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Credential | DPT & LAC
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Telephone | 631-923-0334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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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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