Active NPI
Youngju Lee, RPT
- Physical Therapist
- Fresh Meadows, NY
National Provider Identifier
1184010761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 038675
- Practice address
- 18904 64TH Ave Apt 4K
Fresh Meadows, NY 11365-3842 - Phone
- (718) 939-7999
- NPI assigned
- Apr 10, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 038675 | NY | Primary |
Addresses
Primary practice location
18904 64TH Ave Apt 4K
Fresh Meadows, NY 11365-3842
Mailing address
18904 64TH Ave Apt 4K
Fresh Meadows, NY 11365-3842
Phone (718) 939-7999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 038675 | Other | NY | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038675 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428624000000",
"number": "1184010761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18904 64TH AVE APT 4K",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113653842",
"telephone_number": "718-939-7999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18904 64TH AVE APT 4K",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113653842",
"telephone_number": "718-939-7999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "YOUNGJU",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-10",
"last_updated": "2015-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "038675",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "038675",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresh Meadows, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.