Organization
ON TRACK KIDS THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MASIELLO SLP (DIRECTOR)
(646) 410-6058
Entity
Organization
Contact information
Practice address
70 GREENE ST APT 310, JERSEY CITY, NJ 07302-7590
(646) 410-6058
Mailing address
70 GREENE ST APT 310, JERSEY CITY, NJ 07302-7590
(646) 410-6058
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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