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

Sungguk Bae

Individual provider Physical Therapist · NPI 1043710155

Sungguk Bae is a Physical Therapist in Private Practice in Patchogue, New York. Qualified in 2019, 7 years ago. Licensed in New York.

Years since qualifying
7
Licensed in
NY
In the registry since
2018
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Practice location Address checks out

21 Cleveland St
Patchogue, NY 11772-2815
Phone: (631) 569-9373
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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 041263 (NY)

Record details

NPI number1043710155
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 15, 2018
Last updated in NPPESFebruary 15, 2018
Mailing address21 Cleveland St, Patchogue, NY 11772-2815

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Patchogue