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General NPI Number Information
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NPI Number | 1689964579
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Entity Type | Organization
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Legal Business Name | DEVELOPMENTAL SOLUTIONS PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 04/12/2011
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Last Update Date | 04/12/2011
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Provider Practice Location Address
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Address Line | 1324 SAMANTHA DR
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-1766
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Country | US
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Telephone | 917-435-9517
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Fax |
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Provider Business Mailing Address
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Address Line | 1324 SAMANTHA DR
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-1766
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JASON M KREINDLER
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Credential | P.T.
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Telephone | 917-435-9517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 017653
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License Number State | NY
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