Provider Demographics
NPI:1427595909
Name:COLMENARES, RICHELLE KRISH (PT, DPT)
Entity type:Individual
Prefix:
First Name:RICHELLE
Middle Name:KRISH
Last Name:COLMENARES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:RICHELLE
Other - Middle Name:
Other - Last Name:COLMENARES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2749 JOHN F KENNEDY BLVD APT 2C
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-5540
Mailing Address - Country:US
Mailing Address - Phone:201-888-8944
Mailing Address - Fax:
Practice Address - Street 1:2749 JOHN F KENNEDY BLVD APT 2C
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-5540
Practice Address - Country:US
Practice Address - Phone:201-888-8944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-23
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039949225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist