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General NPI Number Information
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NPI Number | 1730766734
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Entity Type | Organization
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Legal Business Name | LIBERTY PHYSICAL THERAPY REHAB PC
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Dates
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Enumeration Date | 03/25/2021
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 2014 146TH ST APT D
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City | WHITESTONE
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State | NY
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Zip | 11357-3412
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Country | US
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Telephone | 917-763-5612
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Fax | 888-502-9368
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Provider Business Mailing Address
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Address Line | 4312 159TH ST APT 3D
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City | FLUSHING
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State | NY
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Zip | 11358-3177
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Country | US
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Telephone | 917-763-5612
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Fax | 888-502-9368
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YOUNG SOOK CHOI
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Credential | PT
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Telephone | 917-763-5612
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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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