Organization
101 AVENUE PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANGHUN LEE (PRESIDENT)
(516) 472-8761
Entity
Organization
Contact information
Practice address
277 NORTHERN BLVD STE 301, GREAT NECK, NY 11021-4703
(516) 472-7861
Mailing address
277 NORTHERN BLVD STE 301, GREAT NECK, NY 11021-4703
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
36145
NY
Other
Enumeration date
08/26/2017
Last updated
08/26/2017
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