OrganizationActive
101 Avenue Physical Therapy PC
NPI 1710404173 · Physical Therapist · Great Neck, NY
Provider details
- NPI number
- 1710404173
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Authorized official
- Changhun Lee, President
- License
- 36145 (NY)
Practice location
277 Northern Blvd Ste 301
Great Neck, NY 11021-4703
Phone: (516) 472-7861
Mailing address
277 Northern Blvd Ste 301
Great Neck, NY 11021-4703
Registry dates
- Enumerated
- 2017-08-26
- Last updated
- 2017-08-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.