Provider Demographics
NPI:1932464880
Name:KINEMATIC PT PC
Entity Type:Organization
Organization Name:KINEMATIC PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARETSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:212-687-0040
Mailing Address - Street 1:69 8TH AVE APT 31
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-1237
Mailing Address - Country:US
Mailing Address - Phone:917-442-7763
Mailing Address - Fax:
Practice Address - Street 1:315 MADISON AVE RM 806
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5432
Practice Address - Country:US
Practice Address - Phone:212-687-0040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-06
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018570261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy