Provider Demographics
NPI:1699374595
Name:ADVANCED CARE PHYSICAL THERAPY, P.C.
Entity type:Organization
Organization Name:ADVANCED CARE PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEUNGYOUL
Authorized Official - Middle Name:
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:201-500-5571
Mailing Address - Street 1:232 BROAD AVE FRNT 2A
Mailing Address - Street 2:
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-1577
Mailing Address - Country:US
Mailing Address - Phone:201-500-5571
Mailing Address - Fax:
Practice Address - Street 1:232 BROAD AVE FRNT 2A
Practice Address - Street 2:
Practice Address - City:PALISADES PARK
Practice Address - State:NJ
Practice Address - Zip Code:07650-1577
Practice Address - Country:US
Practice Address - Phone:201-500-5571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty