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NPI Code Detail

MEDICARE: PURE BODY PHYSICAL THERAPY P.C.

MEDICARE: PURE BODY PHYSICAL THERAPY P.C.
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 Therapist

General Provider Information

NPI Number : 1457221061
Entity Type Code : Organization
Provider Name (Legal Business Name) : PURE BODY PHYSICAL THERAPY P.C.
Provider Business Mailing Address
First Line : 215 HALLOCK RD STE 2
Second Line :
City : STONY BROOK
State : NY
Zip : 11790-3077
Country : US
Telephone Number : 917-563-1824
Fax Number : 917-779-9959
Provider Business Practice Location Address
First Line : 215 HALLOCK RD STE 2
Second Line :
City : STONY BROOK
State : NY
Zip : 11790-3077
Country : US
Telephone Number : 917-563-1824
Fax Number : 917-779-9959
Authorized Official
Title or Position : PRESIDENT
Name : SUHAN WOO
Credential : PT
Telephone Number : 917-370-7307
Provider Enumeration Date : 11/08/2025
Last Update Date : 02/19/2026

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Directions to “PURE BODY PHYSICAL THERAPY P.C. ” Practice Location

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