Provider Demographics
NPI:1689964579
Name:DEVELOPMENTAL SOLUTIONS PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:DEVELOPMENTAL SOLUTIONS PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:M
Authorized Official - Last Name:KREINDLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-435-9517
Mailing Address - Street 1:1324 SAMANTHA DR
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-1766
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1324 SAMANTHA DR
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-1766
Practice Address - Country:US
Practice Address - Phone:917-435-9517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017653252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency