Organization
8TH AVE PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUNG RYEOL PARK RPT (PRESIDENT)
(718) 423-3400
Entity
Organization
Contact information
Practice address
21915A NORTHERN BLVD, BAYSIDE, NY 11361-3525
(718) 423-3400
(888) 391-2482
Mailing address
219-15A NORTHERN BLVD, BAYSIDE, NY 11361-3525
(718) 423-3400
(888) 391-2482
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
023674
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679742274
NPI
FL
Enumeration date
12/14/2010
Last updated
10/06/2016
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