Provider Demographics
NPI:1902053010
Name:KINESTHESIA PHYSIO, LLC
Entity type:Organization
Organization Name:KINESTHESIA PHYSIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:PARETTI
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT, CSCS
Authorized Official - Phone:212-677-6564
Mailing Address - Street 1:46 E 21ST ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7221
Mailing Address - Country:US
Mailing Address - Phone:212-677-6564
Mailing Address - Fax:212-677-1510
Practice Address - Street 1:46 E 21ST ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7221
Practice Address - Country:US
Practice Address - Phone:212-677-6564
Practice Address - Fax:212-677-1510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024344261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy