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Organization

BALBOA PT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JASON P LAMENDOLA PT (PHYSICAL THERAPIST)
(718) 816-6500
Entity
Organization

Contact information

Practice address
945 HUGUENOT AVE, STATEN ISLAND, NY 10312-4312
(718) 816-6500
(718) 816-4677
Mailing address
945 HUGUENOT AVE, STATEN ISLAND, NY 10312-4312
(718) 816-6500
(718) 816-4677

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0205341
NY

Other

Enumeration date
08/09/2011
Last updated
12/10/2014
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