Great Wall Dynamic Physical Therapy & Acupuncture PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

003017 Issued in NY

Legal business name

GREAT WALL DYNAMIC PHYSICAL THERAPY & ACUPUNCTURE PLLC

Practice address

13939 35TH Ave
Flushing, NY 11354-3500

Phone

(718) 888-2600

NPI assigned

Nov 8, 2011

Last updated

Nov 8, 2011By 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

Qin Everlyn Li, RPT

Title

RPT

Phone

(718) 888-2600

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.

• Qing Evelyn Li, L. AC., DPT

  • Physical Therapist
  • Flushing, NY
  • NPI 1003060120
  NPD (past)

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320710400000",
    "number": "1649557455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 521231",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113521231",
            "telephone_number": "718-888-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13939 35TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113543500",
            "telephone_number": "718-888-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT WALL DYNAMIC PHYSICAL THERAPY & ACUPUNCTURE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "QIN",
        "authorized_official_middle_name": "EVERLYN",
        "authorized_official_title_or_position": "RPT",
        "authorized_official_telephone_number": "718-888-2600",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "003017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "003017",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harold Christian Doriman Gravador
• Connor Daniel Gray, LMSW
• Great Grace Care Corp
• Great Home Adult Daycare Center Inc
• Great Northern Chiropractic PC
• Great Wall Medical PC
• Greater New York Care Inc (Gnyc)
• Greater New York Ophthalmology Eye Care PLLC
• Greater New York Social and Health Adult Day Care
• Greater Queens Podiatry

• Specialist in Flushing, NY
• Providers in Flushing, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.