Organization Active NPI

Liberty Physical Therapy Rehab PC

  • Physical Therapist
  • Whitestone, NY
National Provider Identifier
1730766734
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LIBERTY PHYSICAL THERAPY REHAB PC
Practice address
2014 146TH St Apt D
Whitestone, NY 11357-3412
Phone
(917) 763-5612
Fax
(888) 502-9368
NPI assigned
Mar 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Authorized official

Name
Dr. Young Sook Choi, PTNPI 1295951358
Title
President
Phone
(917) 763-5612

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2014 146TH St Apt D
Whitestone, NY 11357-3412

Mailing address

4312 159TH St Apt 3D
Flushing, NY 11358-3177
Phone (917) 763-5612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210402000778 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3072920347 Receives reassigned benefits from 1 practitioner
Practice locations: Spring Valley, NY; Newburgh, NY; Goshen, NY; Kingston, NY

National Provider Directory

National Provider Directory

Locations

600 Broadway
Newburgh, NY 12550
Phone (585) 204-3533

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616630400000",
    "number": "1730766734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4312 159TH ST APT 3D",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583177",
            "telephone_number": "917-763-5612",
            "fax_number": "888-502-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 146TH ST APT D",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113573412",
            "telephone_number": "917-763-5612",
            "fax_number": "888-502-9368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY PHYSICAL THERAPY REHAB PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A",
        "authorized_official_last_name": "CHOI",
        "authorized_official_first_name": "YOUNG SOOK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-763-5612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitestone, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.