=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790092310
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JUMP START THERAPY, PT, OT, SLP, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/02/2010
-----------------------------------------------------
Last Update Date | 08/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2 INDUSTRIAL DRIVE
-----------------------------------------------------
City | FLORIDA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10921
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-651-2535
-----------------------------------------------------
Fax | 845-827-5496
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2 INDUSTRIAL DRIVE
-----------------------------------------------------
City | FLORIDA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10921
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-651-2535
-----------------------------------------------------
Fax | 845-827-5496
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. JOEL RUBINFELD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 845-324-5729
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number | 016291-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------