Organization
LIBERTY PHYSICAL MEDICINE & REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELYSE CHANG (OFFICE MANAGER)
(718) 651-8414
Entity
Organization
Contact information
Practice address
3755 77TH ST, SUITE 1J, JACKSON HEIGHTS, NY 11372-6603
(718) 651-8414
Mailing address
3755 77TH ST, SUITE 1J, JACKSON HEIGHTS, NY 11372-6603
(718) 651-8414
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
241442
NY
Other
Enumeration date
08/13/2010
Last updated
08/13/2010
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