Organization
PROADVANTAGE PHYSICAL THERAPY INCORPORATED
Active
Organization
PROADVANTAGE PHYSICAL THERAPY INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YEVGENY FEDOSENKO (OWNER)
(617) 620-2137
Entity
Organization
Contact information
Practice address
200 WINSTON DR APT 119, CLIFFSIDE PARK, NJ 07010-3209
(617) 620-2137
Mailing address
200 WINSTON DR APT 119, CLIFFSIDE PARK, NJ 07010-3209
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
40QA01242600
NJ
Other
Enumeration date
08/28/2008
Last updated
03/18/2026
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