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NPI Code Detail

MEDICARE: CORNERSTONE PHYSICAL THERAPY

MEDICARE: CORNERSTONE PHYSICAL THERAPY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist024040NY

General Provider Information

NPI Number : 1447684774
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORNERSTONE PHYSICAL THERAPY
Provider Business Mailing Address
First Line : 115 W 30TH STREET
Second Line : 500B
City : NEW YORK
State : NY
Zip : 10001
Country : US
Telephone Number : 212-764-3924
Fax Number :
Provider Business Practice Location Address
First Line : 115 W 30TH ST
Second Line : 500B
City : NEW YORK
State : NY
Zip : 10001-4010
Country : US
Telephone Number : 212-764-3924
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JUSEOK PARK
Credential :
Telephone Number : 917-750-7722
Provider Enumeration Date : 08/22/2013
Last Update Date : 08/22/2013

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Directions to “CORNERSTONE PHYSICAL THERAPY ” Practice Location

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