Provider Demographics
NPI:1407581044
Name:THERAMOTION PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:THERAMOTION PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KOSTA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOKOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:718-279-9800
Mailing Address - Street 1:21426 41ST AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2166
Mailing Address - Country:US
Mailing Address - Phone:718-279-9800
Mailing Address - Fax:718-279-9500
Practice Address - Street 1:3016 30TH DR FL 2
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-1874
Practice Address - Country:US
Practice Address - Phone:718-279-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THERAMOTION PHYSICAL THERAPY PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy