Provider Demographics
NPI:1346908704
Name:SJ PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:SJ PHYSICAL THERAPY PLLC
Other - Org Name:SERENDIPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-727-1527
Mailing Address - Street 1:63 W 68TH ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5340
Mailing Address - Country:US
Mailing Address - Phone:917-755-6323
Mailing Address - Fax:
Practice Address - Street 1:250 W 54TH ST STE 805
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5558
Practice Address - Country:US
Practice Address - Phone:917-727-1527
Practice Address - Fax:212-202-3652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty