Individual
MR. JUNG SOO BAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA, LMT
Contact information
Practice address
24 SAW MILL RIVER RD, SUITE 204, HAWTHORNE, NY 10532-1541
(914) 631-6969
(914) 631-0943
Mailing address
24 SAW MILL RIVER RD, SUITE 204, HAWTHORNE, NY 10532-1541
(914) 631-6969
(914) 631-0943
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
006279-1
NY
225700000X
Massage Therapist
Primary
023459-1
NY
Other
Enumeration date
06/03/2010
Last updated
06/03/2010
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