OrganizationVladimir Fedosseev Physical Therapy Pc(<Unavail>)Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address3371 Richmond Ave, Lower Level Ste, Staten Island, NY 10312-2025(718) 808-9337PECOS EnrollmentBased on the most recent information from CMS, provider Vladimir Fedosseev Physical Therapy Pc 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 ID1407418635Provider TypeOrganizationFull NameVladimir Fedosseev Physical Therapy PcOther Name<Unavail>SubpartNoEnumeration Date7/9/2019Last Updated7/17/2020Contact InformationPractice LocationPractice Address3371 Richmond Ave, Lower Level Ste, Staten Island, NY 10312-2025Phone(718) 808-9337FaxUnlisted FaxMailing LocationMailing Address3371 Richmond Ave Lowr Level, Staten Island, NY 10312-2025Phone(718) 808-9337Fax(347) 983-6126Authorized OfficialNameFedosseev, Vladimir (Owner)Phone(718) 808-9337Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted Issuer