Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Fresh Pond Physical Therapy Astoria, PC

Organization Physical Therapist · NPI 1477819084

Fresh Pond Physical Therapy Astoria, PC is a Physical Therapist in Astoria, New York. Licensed in New York. Registered with an NPI since 2012.

Licensed in
NY
In the registry since
2012
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4618 Broadway
Astoria, NY 11103-1628
Phone: (718) 274-4200
Fax: (718) 559-6784
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 015401-1 (NY)

Record details

NPI number1477819084
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Liza Tan — Ceo · (718) 456-2543
NPI enumeratedApril 9, 2012
Last updated in NPPESMay 20, 2016
Mailing address6805 Fresh Pond Rd, Ridgewood, NY 11385-5200

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