Provider Demographics
NPI:1184063117
Name:ON A ROLL PHYSICAL AND OCCUPATIONAL THERAPY SERVICES, PLLC
Entity type:Organization
Organization Name:ON A ROLL PHYSICAL AND OCCUPATIONAL THERAPY SERVICES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MINKEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-428-7564
Mailing Address - Street 1:25 ELM PL FL 5
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5826
Mailing Address - Country:US
Mailing Address - Phone:917-428-7564
Mailing Address - Fax:
Practice Address - Street 1:25 ELM PL FL 5
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5826
Practice Address - Country:US
Practice Address - Phone:212-584-2502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-24
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008801-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy