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Organization
JUMP START THERAPY PLACE
Active
Organization
JUMP START THERAPY PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YELENA NEMTSOVA PT, DPT (PRESIDENT)
(917) 622-2612
Entity
Organization
Contact information
Practice address
4131 RICHMOND AVE, STATEN ISLAND, NY 10312-5633
(718) 351-0308
Mailing address
4131 RICHMOND AVE, STATEN ISLAND, NY 10312-5633
(718) 351-0308
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05516
NY
225X00000X
Occupational Therapist
006852
NY
Other
Enumeration date
04/09/2012
Last updated
10/12/2016
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