Organization
SAMUEL YOO PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL YOO PT (PT)
(646) 240-8453
Entity
Organization
Contact information
Practice address
3930 RICHMOND AVE STE 200, STATEN ISLAND, NY 10312-5103
(718) 317-9801
Mailing address
3930 RICHMOND AVE STE 200, STATEN ISLAND, NY 10312-5103
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891939625
—
NY
01
—
A400026932
MEDICARE MEMBER PTAN FOR BROOKLYN, STATEN ISLAND, MANHATTAN
NY
01
—
G400061606
MEDICARE MEMBER PTAN FOR QUEENS
NY
Enumeration date
02/21/2022
Last updated
06/22/2023
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