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General NPI Number Information
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NPI Number | 1982004958
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Entity Type | Organization
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Legal Business Name | J. LAMENDOLA PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 08/27/2014
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Last Update Date | 08/08/2022
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Provider Practice Location Address
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Address Line | 1100 CLOVE RD SUITE GC
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City | STATEN ISLAND
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State | NY
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Zip | 10301-3648
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Country | US
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Telephone | 718-816-6500
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Fax | 718-816-4677
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Provider Business Mailing Address
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Address Line | 1100 CLOVE RD SUITE GC
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City | STATEN ISLAND
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State | NY
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Zip | 10301-3648
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Country | US
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Telephone | 718-816-6500
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Fax | 718-816-4677
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. JASON PAUL LAMENDOLA
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Credential | P.T.
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Telephone | 718-816-6500
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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 | 02025341
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License Number State | NY
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