Park Avenue Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PARK AVENUE PHYSICAL THERAPY PC

Doing business as

Brook Physical Therapy PC

Practice address

207 Hallock Rd Ste 209
Stony Brook, NY 11790-3082

Phone

(631) 338-8516

Fax

(518) 984-3120

NPI assigned

Nov 12, 2021

Organization subpart

No

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

Authorized official

Name

Jessie J Kim, PTNPI 1306375258

Title

Owner

Phone

(631) 338-8516

Specialties & licenses 1

Addresses

Other names 1

• Brook Physical Therapy PC Doing business as

Locations

Practitioners 1

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

• Jessie Kim

  • Physical Therapist
  • New York, NY
  • NPI 1306375258
  NPD Authorized official

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704499200000",
    "number": "1982360038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 HALLOCK RD STE 209",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903082",
            "telephone_number": "631-338-8516",
            "fax_number": "518-984-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 HALLOCK RD STE 209",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903082",
            "telephone_number": "631-338-8516",
            "fax_number": "518-984-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-12",
        "last_updated": "2024-01-06",
        "certification_date": "2024-01-06",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-338-8516",
        "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": [
        {
            "organization_name": "Brook Physical Therapy PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aruna Parekh, MD
• Parents for Megan'S Law, Inc.
• Apurva Parikh
• Puja Parikh, M.D.
• Shruti Parikh, MD
• Jason Park
• Jiyeon Park, MD
• Michael Jung Hoon Park, M.D.
• Sherwin Park, M.D.
• Tae Park, M.D.

• Physical Therapist in Stony Brook, NY
• Providers in Stony Brook, 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 Jan 6, 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.