Organization
LIBERTY PHYSICAL MEDICINE AND REHABILITATION, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN M. CHANG M.D. (PRESIDENT)
(718) 651-8414
Entity
Organization
Contact information
Practice address
4037 81ST ST, ELMHURST, NY 11373-1393
(718) 651-8414
(718) 651-8413
Mailing address
4037 81ST ST, ELMHURST, NY 11373-1393
(718) 651-8414
(718) 651-8413
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
A2414421
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154401883
NPI TYPE 1
NY
Enumeration date
04/24/2014
Last updated
04/24/2014
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