Provider Demographics
NPI:1548032154
Name:FELDENKRAIS ETC, LLC
Entity type:Organization
Organization Name:FELDENKRAIS ETC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MISIURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-765-4800
Mailing Address - Street 1:30 MELROSE TER UNIT 318
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-6857
Mailing Address - Country:US
Mailing Address - Phone:212-765-4800
Mailing Address - Fax:
Practice Address - Street 1:30 E 60TH ST RM 206
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-7111
Practice Address - Country:US
Practice Address - Phone:212-765-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-26
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty