| Organization Name: | FRESH POND PHYSICAL THERAPY ASTORIA, P.C. |
| NPI Number: | 1477819084 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LIZA TAN (CEO) |
| Mailing Address: | 4618 Broadway Astoria |
| State: | NY US |
| Postal Code: | 111031628 |
| Phone Number: | 7182744200 |
| Fax Number: | 7185596784 |
| NPI Enumeration Date: | 04/09/2012 |
| NPI Last Update Date: | 05/20/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 015401-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |