Provider Demographics
NPI:1437618782
Name:KJ PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:KJ PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEARNS
Authorized Official - Middle Name:
Authorized Official - Last Name:JULIEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:347-267-8157
Mailing Address - Street 1:520 W 218TH ST APT 3B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1025
Mailing Address - Country:US
Mailing Address - Phone:347-267-8156
Mailing Address - Fax:347-618-4347
Practice Address - Street 1:520 W 218TH ST APT 3B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-1025
Practice Address - Country:US
Practice Address - Phone:347-267-8156
Practice Address - Fax:347-618-4347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-17
Last Update Date:2019-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy