MEDICARE: JDK PHYSICAL THERAPY PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1558229922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JDK PHYSICAL THERAPY PC

Provider Business Mailing Address
First Line	:	2003 HANCOCK AVE
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-1514
Country	:	US
Telephone Number	:	516-445-0838
Fax Number	:	516-445-0838

Provider Business Practice Location Address
First Line	:	2003 HANCOCK AVE
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-1514
Country	:	US
Telephone Number	:	516-445-0838
Fax Number	:	516-445-0838

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	JENNIFER DIANE KOLASINSKI
Credential	:	DPT
Telephone Number	:	516-445-0838

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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