Organization
REPAIR PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC CHAN DPT (PRESIDENT/ PHYSICAL THERAPIST)
(347) 248-6138
Entity
Organization
Contact information
Practice address
204 EAST 25TH STREET, SUITE 1, NEW YORK, NY 10010
(347) 248-6138
Mailing address
5113 61ST ST, WOODSIDE, NY 11377-5831
(347) 248-6138
(212) 877-5504
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
Other
Enumeration date
01/20/2020
Last updated
03/16/2021
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