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General NPI Number Information
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NPI Number | 1508396979
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Entity Type | Organization
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Legal Business Name | JSB LLC
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Dates
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Enumeration Date | 06/18/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 5615 251ST ST STE 1
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City | LITTLE NECK
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State | NY
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Zip | 11362-2117
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Country | US
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Telephone | 516-387-6333
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Fax | 718-639-1233
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Provider Business Mailing Address
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Address Line | 5615 251ST ST STE 1
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City | LITTLE NECK
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State | NY
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Zip | 11362-2117
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Country | US
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Telephone | 516-387-6333
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Fax | 718-639-1233
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Authorized Official
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Title or Position | PARTNER
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Name | JEFFREY KIM
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Credential | D.P.T.
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Telephone | 516-387-6333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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