Core Balance Physical Therapy, P.C.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

CORE BALANCE PHYSICAL THERAPY, P.C.

Practice address

4029 235TH St FL 2
Douglaston, NY 11363-1509

Phone

(718) 359-1004

Fax

(718) 691-4053

NPI assigned

Apr 24, 2023

Last updated

Dec 2, 2024By 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

Mr. Wooyoung Bae, DPTNPI 1194369595

Title

President

Phone

(929) 225-3210

Specialties & licenses 1

Addresses

Locations

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.

• Wooyoung Bae

  • Physical Therapist
  • Douglaston, NY
  • NPI 1194369595
  Authorized official Same address or phone

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1669169108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4029 235TH ST FL 2",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "113631509",
            "telephone_number": "718-359-1004",
            "fax_number": "718-691-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4029 235TH ST FL 2",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "113631509",
            "telephone_number": "718-359-1004",
            "fax_number": "718-691-4053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15644 Northern Blvd Ste D",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113545066",
            "country_code": "US",
            "telephone_number": "718-359-1004",
            "fax_number": "718-691-4053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CORE BALANCE PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "BAE",
        "authorized_official_first_name": "WOOYOUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "929-225-3210",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Young Chan Cho
• Gail Elizabeth Clark, MA/SLP
• Regina Cohen, LCSW
• Gregory David Cohn, D.M.D.
• Aaron Cooper, LCSW
• Barney Anthony Cosenza, LMT
• Stefania Cuomo
• CVS Albany LLC (CVS Pharmacy# 00560)
• Jordana Rachel Davidson
• David De la Rosa, CASAC

• Physical Therapist in Douglaston, NY
• Providers in Douglaston, 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 Dec 2, 2024; 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.