Provider Demographics
NPI:1265707780
Name:JAMES A KENNEDY PHYSICAL THERAPIST PLLC
Entity type:Organization
Organization Name:JAMES A KENNEDY PHYSICAL THERAPIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ASSADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-981-1981
Mailing Address - Street 1:61 BROADWAY RM 2824
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-2816
Mailing Address - Country:US
Mailing Address - Phone:212-981-1981
Mailing Address - Fax:
Practice Address - Street 1:61 BROADWAY RM 2824
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-2816
Practice Address - Country:US
Practice Address - Phone:212-981-1981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management