Provider Demographics
NPI:1982211033
Name:KINETIC TOUCH PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:KINETIC TOUCH PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOMAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LUMAGUI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:718-406-7689
Mailing Address - Street 1:4237 JUDGE ST BSMT
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2554
Mailing Address - Country:US
Mailing Address - Phone:718-406-7689
Mailing Address - Fax:718-446-1984
Practice Address - Street 1:3744 75TH ST BSMT
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6444
Practice Address - Country:US
Practice Address - Phone:718-406-7689
Practice Address - Fax:718-446-1984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty