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

Fresh Pond Physical Therapy Jackson Heights, PC

Organization Physical Therapist · NPI 1093111023

Fresh Pond Physical Therapy Jackson Heights, PC provides Physical Therapist services in Jackson Heights, New York. Licensed in New York. Registered with an NPI since 2014.

Licensed in
NY
In the registry since
2014
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

9216 Roosevelt Ave
Jackson Heights, NY 11372-7942 Not confirmed with CMS for 10 years — call before visiting
Phone: (718) 456-2545
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 (NY)

Record details

NPI number1093111023
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Liza Tan — President · (718) 456-2545
NPI enumeratedNovember 19, 2014
Last updated in NPPESMay 20, 2016
Mailing address6805 Fresh Pond Rd, Ridgewood, NY 11385-5200

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