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General NPI Number Information
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NPI Number | 1134241698
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Entity Type | Organization
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Legal Business Name | THERAMOTION PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 21426 41ST AVE STE 130
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City | BAYSIDE
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State | NY
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Zip | 11361-2166
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Country | US
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Telephone | 718-279-9800
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Fax | 718-279-9500
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Provider Business Mailing Address
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Address Line | 21426 41ST AVE STE 130
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City | BAYSIDE
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State | NY
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Zip | 11361-2166
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Country | US
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Telephone | 718-279-9800
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Fax | 718-279-9500
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Authorized Official
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Title or Position | OWNER
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Name | KOSTA KOKOLIS
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Credential |
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Telephone | 718-279-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 023936-1
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License Number State | NY
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