101 Avenue Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

36145 Issued in NY

Legal business name

101 AVENUE PHYSICAL THERAPY PC

Practice address

277 Northern Blvd Ste 301
Great Neck, NY 11021-4703

Phone

(516) 472-7861

NPI assigned

Aug 26, 2017

Last updated

Aug 26, 2017By 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

Changhun LeeNPI 1780062497

Title

President

Phone

(516) 472-8761

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.

• Chang Hun Lee

  • Physical Therapist
  • Mineola, NY
  • NPI 1780062497
  NPD Authorized official

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

{
    "created_epoch": "1503705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503705600000",
    "number": "1710404173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 NORTHERN BLVD STE 301",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 NORTHERN BLVD STE 301",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214703",
            "telephone_number": "516-472-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "101 AVENUE PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-26",
        "last_updated": "2017-08-26",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "CHANGHUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-472-8761"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "36145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 120 And Beyond Social Adult Day Care, LLC (120 and Beyond Senior Center)
• 307 Long Island Medical PC
• 3P Omics, Inc. (Tovana Health)
• 885 Operatory Inc
• Aaa Vascular Care PLLC

• Physical Therapist in Great Neck, NY
• Providers in Great Neck, 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 Aug 26, 2017; 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.