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General NPI Number Information
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NPI Number | 1952016966
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Entity Type | Organization
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Legal Business Name | KOOL KIDZ PHYSICAL THERAPY
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Dates
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Enumeration Date | 01/16/2023
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Last Update Date | 01/16/2023
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Provider Practice Location Address
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Address Line | 219 TAYLORS MILLS RD
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City | MANALAPAN
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State | NJ
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Zip | 07726-3255
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Country | US
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Telephone | 347-543-7236
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Fax |
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Provider Business Mailing Address
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Address Line | 132 RADIGAN AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10309-4215
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Country | US
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Telephone | 347-543-7236
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Fax |
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | CHRISTINA RUBIN
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Credential | DPT
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Telephone | 347-543-7236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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