Individual ProviderVladimir FedosseevPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address3371 Richmond Ave Lowr Level, Staten Island, NY 10312-2025(718) 808-9337PECOS EnrollmentBased on the most recent information from CMS, provider Vladimir Fedosseev does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1023470093Provider TypeIndividualFull NameFedosseev, VladimirCredentialPT, DPTGenderMaleSole ProprietorNoEnumeration Date3/28/2016Last Updated7/17/2020Contact InformationPractice LocationPractice Address3371 Richmond Ave Lowr Level, Staten Island, NY 10312-2025Phone(718) 808-9337Fax(347) 983-6126Mailing LocationMailing Address3371 Richmond Ave Lowr Level, Staten Island, NY 10312-2025Phone(718) 808-9337Fax(347) 983-6126Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense038352-1New York