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Jump Start Therapy Place

Physical Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

4131 Richmond Ave, Staten Island, NY 10312-5633

PECOS Enrollment

Based on the most recent information from CMS, provider Jump Start Therapy Place does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1316203946
Provider Type
Organization
Full Name
Jump Start Therapy Place

Subpart
No
Enumeration Date
4/9/2012
Last Updated
10/12/2016

Contact Information

Practice Location

4131 Richmond Ave, Staten Island, NY 10312-5633

(718) 351-0308

Unlisted Fax

Mailing Location

4131 Richmond Ave, Staten Island, NY 10312-5633

(718) 351-0308

Unlisted Fax

Authorized Official

Nemtsova, Yelena (President)

(917) 622-2612

Provider Taxonomies

Code	Description	License
Code 225100000X Primary	Description Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License 05516 New York
Code 225X00000X	Description Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License 006852 New York

Jump Start Therapy Place

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Aitken-Douyon, Karen A

Greenridge Physical Therapy Pc

Swaminarayan, Brinda

Pacchiano, Mark Anthony

Cregin, Julie Kristen

Ranganathan, Swethambari

Camacho-Luque, Martha

Healing Hands Physical Therapy & Wellness Pllc

Felix, Nemesio Cruz

Vandevender, Jeremy C