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General NPI Number Information
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NPI Number | 1992436117
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Entity Type | Organization
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Legal Business Name | BAN PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 290 MADISON AVE STE 601
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City | NEW YORK
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State | NY
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Zip | 10017-6308
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Country | US
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Telephone | 224-423-8053
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Fax | 973-915-7116
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Provider Business Mailing Address
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Address Line | 290 MADISON AVE STE 601
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City | NEW YORK
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State | NY
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Zip | 10017-6308
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Country | US
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Telephone | 224-423-8053
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Fax | 973-915-7116
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Authorized Official
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Title or Position | PROVIDER
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Name | MYEONGJI BAN
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Credential |
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Telephone | 224-423-8053
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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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