Healthcare Provider Details

I. General information

NPI: 1538022686
Provider Name (Legal Business Name): JMS THERAPEUTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 WALL ST STE 211
NORWALK CT
06850-3403
US

IV. Provider business mailing address

2389 MAIN ST STE 100
GLASTONBURY CT
06033-4617
US

V. Phone/Fax

Practice location:
  • Phone: 718-775-6978
  • Fax:
Mailing address:
  • Phone: 718-775-6978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MITCHELL TEODOSIO SASIS
Title or Position: OWNER
Credential: DPT
Phone: 718-775-6978