Provider Demographics
NPI:1053048454
Name:JESSICA BABICH PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:JESSICA BABICH PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:BABICH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CFMT
Authorized Official - Phone:810-923-1483
Mailing Address - Street 1:260 E 78TH ST APT 7
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-2099
Mailing Address - Country:US
Mailing Address - Phone:810-923-1483
Mailing Address - Fax:
Practice Address - Street 1:260 E 78TH ST APT 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-2099
Practice Address - Country:US
Practice Address - Phone:810-923-1483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty