Organization
GRASMERE PHYSICAL THERAPY WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IGOR TSERLYUK DPT (PHYSICAL THERAPIST/OWNER)
(718) 442-1003
Entity
Organization
Contact information
Practice address
1130 VICTORY BLVD, STATEN ISLAND, NY 10301-3623
(718) 442-1003
(718) 442-1150
Mailing address
1130 VICTORY BLVD, STATEN ISLAND, NY 10301-3623
(718) 442-1003
(718) 442-1150
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215507579
NPI
NY
01
—
1568235760
NPI
NY
Enumeration date
02/26/2025
Last updated
03/17/2025
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