Provider Demographics
NPI:1578873063
Name:JUMP START THERAPY, LLP
Entity Type:Organization
Organization Name:JUMP START THERAPY, LLP
Other - Org Name:JUMP START THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGO
Authorized Official - Middle Name:
Authorized Official - Last Name:LICHTENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:732-462-3300
Mailing Address - Street 1:962 MANOR RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-7011
Mailing Address - Country:US
Mailing Address - Phone:718-982-5944
Mailing Address - Fax:718-494-2724
Practice Address - Street 1:219 TAYLORS MILLS RD
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3229
Practice Address - Country:US
Practice Address - Phone:718-982-5944
Practice Address - Fax:718-494-2724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty