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NPI Code Detail

MEDICARE: YOUNGSU NA PT

MEDICARE: YOUNGSU NA PT
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 Therapist043571NY

General Provider Information

NPI Number : 1770249914
Entity Type Code : Individual
Provider Name (Legal Business Name) : YOUNGSU NA PT
Provider Business Mailing Address
First Line : 42 BROADWAY STE 1219
Second Line :
City : NEW YORK
State : NY
Zip : 10004-3834
Country : US
Telephone Number : 929-412-2654
Fax Number : 929-412-2686
Provider Business Practice Location Address
First Line : 42 BROADWAY STE 1219
Second Line :
City : NEW YORK
State : NY
Zip : 10004-3834
Country : US
Telephone Number : 929-412-2654
Fax Number : 929-412-2686
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2021
Last Update Date : 05/15/2024

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Directions to “ YOUNGSU NA PT” Practice Location

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