Chiwon Ahn

Individual provider Active NPI Physical Therapist · Fort Lee, NJ

NPI 1750142626 · NPPES record last updated Jan 18, 2024

Key facts

NPI
1750142626
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
2200 Fletcher Ave Ste 505
Fort Lee, NJ 07024-5016
Phone
(201) 849-5201
Fax
(201) 849-5014
NPI assigned
Jan 18, 2024
Sex
Male
Sole proprietor
Yes

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Occupational and Physical Therapy, PLLC (497 clinicians)

Practice addresses (Care Compare)

2200 Fletcher Ave
Suite 505
Fort Lee, NJ 07024-5016
Phone (201) 849-5201

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240528000894 NJ Practitioner - Physical Therapist in Private Practice 7517309222 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current
since May 13, 2024
Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current
since May 13, 2024
Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients

Locations

2200 Fletcher Ave
Ste 505
Fort Lee, NJ 07024
Phone (201) 849-5201

1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424

524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591

576 Broadhollow Rd
Melville, NY 11747

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NJ Yes

Addresses

Primary practice location

2200 Fletcher Ave Ste 505
Fort Lee, NJ 07024-5016

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002

Other providers in Fort Lee, NJ

All providers in Fort Lee, NJ · Physical Therapist in New Jersey

Sources for this page

Verify at the official NPI Registry.