LIBERTY PHYSICAL MEDICINE AND REHABILITATION, P.C. (NPI# 1306266721) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306266721 |
| Entity Type | Organization |
| Organization Name | LIBERTY PHYSICAL MEDICINE AND REHABILITATION, P.C. |
| Practice Address |
4037 81st St Elmhurst NY 11373-1393 |
| Practice Telephone | 7186518414 |
| Practice Fax Number | 7186518413 |
| Mailing Telephone | 7186518414 |
| Mailing Fax Number | 7186518413 |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2014-04-24 |
| Authorized Official Name | DR. BENJAMIN M. CHANG (PRESIDENT) |
| Authorized Official Telephone | 7186518414 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
A2414421 | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NPI TYPE 1 | 1154401883 | 01 |
| Street Address |
4037 81ST ST |
| City | ELMHURST |
| State | NY |
| Zip Code | 11373-1393 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154401883 | Benjamin Minsoo Chang | Physical Medicine & Rehabilitation | 4037 81st St, Elmhurst, NY 11373-1393 | 2006-10-17 |
| 1467863266 | Remalyn Tampepe | Physical Therapist | 4037 81st St, Elmhurst, NY 11373-1393 | 2014-05-14 |
| 1275693012 | Wilfredo Talavera | Internal Medicine | 4037 81st St, Elmhurst, NY 11373-1379 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376152736 | Carlos Eduardo Hallo Carrasco | Student in an Organized Health Care Education/Training Program | 79-01 Broadway, 10, C 10-19a, Elmhurst, NY 11373 | 2020-07-30 |
| 1912524034 | Jurian Feygen Kaunang | Student in an Organized Health Care Education/Training Program | Bronx-lebanon Hospital Center, 1650 Grand Concourse, Bronx, NY 11373 | 2020-07-06 |
| 1407471352 | Shreeya Parajull | Student in an Organized Health Care Education/Training Program | 79-01 Broadway Elmhurst Hospital Center:, Room A7-34, Elmhurst, NY 11373 | 2020-06-16 |
| 1114542479 | Mahmud Omar Elfituri | Student in an Organized Health Care Education/Training Program | 79-01 Boradway, Elmhurst, NY 11373 | 2020-06-12 |
| 1568091452 | Nudjarin Unsin | Licensed Practical Nurse | 7517 41stave, Apt.f3, Elmhurst, NY 11373 | 2020-04-03 |
| 1154969053 | Joshua Reyes | Physician Assistant | 8839 Saint James Ave, Elmhurst, NY 11373 | 2019-12-11 |
| 1821647926 | Shahorin Monzoor | Student in an Organized Health Care Education/Training Program | 81 14 Queens Boulavard, 1st Floor, Elmhurst, NY 11373 | 2019-09-11 |
| 1174184600 | Zoila Josefina Cano Rodriguez | Student in an Organized Health Care Education/Training Program | 7802 41st Ave, Elmhurst, NY 11373 | 2019-06-25 |
| 1891355756 | Kanghee Cho | Registered Nurse | 4143 77th St Elmhurst, Elmhurst, NY 11373 | 2019-06-13 |
| 1861971947 | Allen G Luke | Acupuncturist | 86-21 53 Ave, Elmhurst, NY 11373 | 2018-08-09 |
| Find all providers in zip 11373 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053919589 | Hun K Physical Therapy P.C. | Clinic/Center | 4015 81st St Apt A65, Elmhurst, NY 11373-1343 | 2020-10-16 |
| 1508499328 | Form & Function Physical Therapy, LLC | Clinic/Center | 509 S Stratford Ave, Elmhurst, IL 60126-4121 | 2020-02-20 |
| 1609330422 | Grace Francisco Services Inc | Clinic/Center | 8715 Justice Ave Fl 1, Elmhurst, NY 11373-4556 | 2019-01-25 |
| 1770015216 | Cygnificare Pt, P.C. | Clinic/Center | 9425 53rd Ave, Elmhurst, NY 11373-4611 | 2017-04-03 |
| 1740634237 | Elsanaa Pt PC | Clinic/Center | 8609 51st Ave, Elmhurst, NY 11373-3923 | 2016-04-20 |
| 1871912584 | Concierge Physical Therapy Ltd. | Clinic/Center | 444 N York St, Elmhurst, IL 60126-5512 | 2014-04-09 |
| 1093130056 | Lester Duldulao | Clinic/Center | 9030 55th Ave Apt 3, Elmhurst, NY 11373-4561 | 2014-02-27 |
| 1154660074 | All Well Physical Therapy and Acupuncture P.c | Clinic/Center | 9231 57th Ave Apt 5d, Elmhurst, NY 11373-5062 | 2013-02-13 |
| 1184905085 | Myla Yuzon Belmonte | Clinic/Center | 8706 58th Ave, Elmhurst, NY 11373-4821 | 2011-09-06 |
| 1154326130 | Rci Wrs Inc | Clinic/Center | 275 N York St, Elmhurst, IL 60126-2766 | 2005-06-16 |
| Find all providers in ELMHURST | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.