Provider Demographics
NPI:1962872564
Name:STAYFIT MEDICAL CO
Entity type:Organization
Organization Name:STAYFIT MEDICAL CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL RHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:YELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYUTERSHTEYN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-974-7441
Mailing Address - Street 1:267 DOVER ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3721
Mailing Address - Country:US
Mailing Address - Phone:917-974-7441
Mailing Address - Fax:
Practice Address - Street 1:267 DOVER ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3721
Practice Address - Country:US
Practice Address - Phone:917-974-7441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022678251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health