Provider Demographics
NPI:1982004958
Name:J. LAMENDOLA PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:J. LAMENDOLA PHYSICAL THERAPY, P.C.
Other - Org Name:TLC PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:LAMENDOLA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-816-6500
Mailing Address - Street 1:1100 CLOVE RD
Mailing Address - Street 2:SUITE GC
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-3648
Mailing Address - Country:US
Mailing Address - Phone:718-816-6500
Mailing Address - Fax:718-816-4677
Practice Address - Street 1:1100 CLOVE RD
Practice Address - Street 2:SUITE GC
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-3648
Practice Address - Country:US
Practice Address - Phone:718-816-6500
Practice Address - Fax:718-816-4677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02025341225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty