Basic Information
| Provider Information | |||||||||
| NPI: | 1902050461 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CNS PHYSICAL THERAPY & ACUPUNCTURE, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 520112 | ||||||||
| Address2: | |||||||||
| City: | FLUSHING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113520112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188868180 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6123 229TH ST | ||||||||
| Address2: | |||||||||
| City: | OAKLAND GARDENS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113642422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188868180 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2008 | ||||||||
| LastUpdateDate: | 11/11/2008 | ||||||||
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| AuthorizedOfficialLastName: | KIM | ||||||||
| AuthorizedOfficialFirstName: | TAEJUNG | ||||||||
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| AuthorizedOfficialTitleorPosition: | PT | ||||||||
| AuthorizedOfficialTelephone: | 7188868180 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 022985 | NY | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.