Organization
THERAYOUTH FOUNDATION
Active
Other names
TheraYouth
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA MARCOFF DPT (OWNER)
(516) 770-2055
Entity
Organization
Contact information
Practice address
571 CENTRAL AVE STE 106, NEW PROVIDENCE, NJ 07974-1547
(516) 770-2055
Mailing address
571 CENTRAL AVE STE 106, NEW PROVIDENCE, NJ 07974-1547
(516) 770-2055
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Enumeration date
08/16/2022
Last updated
08/31/2022
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