MEDICARE: DHW PHYSICAL THERAPY WELLNESS PC

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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1952112393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DHW PHYSICAL THERAPY WELLNESS PC

Provider Business Mailing Address
First Line	:	6405 YELLOWSTONE BLVD PH 516
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-1574
Country	:	US
Telephone Number	:	718-489-0287
Fax Number	:	917-905-2055

Provider Business Practice Location Address
First Line	:	2705 41ST AVE APT COMMON5
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-3768
Country	:	US
Telephone Number	:	718-489-0287
Fax Number	:	917-905-2055

Authorized Official
Title or Position	:	DPT/PRESIDENT
Name	:	DR. ZIHAO DU
Credential	:	DPT
Telephone Number	:	917-498-8229

Provider Enumeration Date	:	01/15/2025
Last Update Date	:	02/27/2025

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