8TH Ave Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

023674 Issued in NY

Legal business name

8TH AVE PHYSICAL THERAPY PC

Practice address

21915A Northern Blvd
Bayside, NY 11361-3525

Phone

(718) 423-3400

Fax

(888) 391-2482

NPI assigned

Dec 14, 2010

Last updated

Oct 6, 2016By 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

Jung Ryeol Park, RPTNPI 1679742274

Title

President

Phone

(718) 423-3400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 7

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.

• Jung Ryeol Park, RPT

  • Physical Therapist
  • Bayside, NY
  • NPI 1679742274
  Medicare reassignment NPD Authorized official
• Yoen Cho, RPT

  • Physical Therapist
  • Bayside, NY
  • NPI 1114196714
  Medicare reassignment NPD
• Yujin Gang, RPT

  • Physical Therapist
  • Bayside, NY
  • NPI 1609309392
  NPD (past)
• Eunmi Im

  • Physical Therapy Assistant
  • Flushing, NY
  • NPI 1215470760
  NPD (past)
• Seongsik Kim, P.T.

  • Physical Therapist
  • Flushing, NY
  • NPI 1598053530
  NPD (past)
• Myung Hun Lee, RPT

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1053671412
  NPD (past)
• Seung Woon Lee, DPT & LAC

  • Physical Therapist
  • Flushing, NY
  • NPI 1295027456
  NPD (past)

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1588967475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219-15A NORTHERN BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613525",
            "telephone_number": "718-423-3400",
            "fax_number": "888-391-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21915A NORTHERN BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613525",
            "telephone_number": "718-423-3400",
            "fax_number": "888-391-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "8TH AVE PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-14",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JUNG RYEOL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-423-3400",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "023674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1679742274",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Bayside, NY
• Providers in Bayside, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.