Provider Demographics
NPI:1952884934
Name:JUMPING FEET MGMT CORP.
Entity type:Organization
Organization Name:JUMPING FEET MGMT CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TARYN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:646-258-6448
Mailing Address - Street 1:175 19TH ST APT 501
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-1026
Mailing Address - Country:US
Mailing Address - Phone:646-258-6448
Mailing Address - Fax:
Practice Address - Street 1:175 19TH ST APT 501
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-1026
Practice Address - Country:US
Practice Address - Phone:646-258-6448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty