| Ki Sum Fan, | |
|
15253 10th Ave, Whitestone, NY 11357-1252 | |
| (718) 587-0850 | |
| Not Available |
| Full Name | Ki Sum Fan |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 15253 10th Ave, Whitestone, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467266122 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 053617 (New York) | Primary |
| Provider Name | Sports Physical Therapy Occupational Therapy And Rehabilitation Servic |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1770540593 PECOS PAC ID: 0446140446 Enrollment ID: O20040315001603 |
| Mailing Address | Practice Location Address |
|---|---|
| Ki Sum Fan, 972 Brush Hollow Rd Fl 4, Westbury, NY 11590-1740 Ph: (516) 474-2816 | Ki Sum Fan, 15253 10th Ave, Whitestone, NY 11357-1252 Ph: (718) 587-0850 |
Thomas Chang, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2142 Utopia Pkwy, Whitestone, NY 11357 Phone: 718-767-0610 Fax: 718-767-0260 | |
Stephanie Lescouflair, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2142 Utopia Pkwy, Whitestone, NY 11357 Phone: 718-767-0260 Fax: 718-767-0260 | |
Khalid Aboelmaaty, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1752 Francis Lewis Blvd, Whitestone, NY 11357 Phone: 917-724-4330 Fax: 718-746-4963 | |
Farrah Brittany Margolin, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2142 Utopia Pkwy, Whitestone, NY 11357 Phone: 718-767-0610 Fax: 718-767-0260 | |
Raymon Lukose, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2142 Utopia Pkwy, Whitestone, NY 11357 Phone: 718-767-0610 Fax: 516-750-9076 | |
Richard Victor Lenz, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2142 Utopia Pkwy, Whitestone, NY 11357 Phone: 718-767-0610 Fax: 718-767-0260 | |
Mingshang Yu, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 15714 20th Rd, Whitestone, NY 11357 Phone: 646-867-9686 |