Liberty Physical Medicine and Rehabilitation, P.C.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

A2414421 Issued in NY

Legal business name

LIBERTY PHYSICAL MEDICINE AND REHABILITATION, P.C.

Practice address

4037 81St St
Elmhurst, NY 11373-1393

Phone

(718) 651-8414

Fax

(718) 651-8413

NPI assigned

Apr 24, 2014

Last updated

Apr 24, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Benjamin M. Chang, M.D.NPI 1154401883

Title

President

Phone

(718) 651-8414

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benjamin Minsoo Chang, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Elmhurst, NY
  • NPI 1154401883
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1306266721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4037 81ST ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731393",
            "telephone_number": "718-651-8414",
            "fax_number": "718-651-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4037 81ST ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731393",
            "telephone_number": "718-651-8414",
            "fax_number": "718-651-8413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY PHYSICAL MEDICINE AND REHABILITATION, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-651-8414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "A2414421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1154401883",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yong-Ping Stacey Li, M.S.W
• Zhengdao Li, DDS
• Yahui Liang
• Zhen Hong Liang
• Pamela Benyun Liaw, RPH
• Jennifer Denise Liburd, M.D.
• Justine Licato
• Regina Lichtsztral, M.D.
• Joseph J. Lieber, M.D.
• Laurie Lieberman, LMSW

• Physical Therapy Clinic/Center in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.