MEDICARE: JEFFREY BILGER D.P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	027083-1	NY

General Provider Information

NPI Number	:	1093767626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY BILGER D.P.T.

Provider Business Mailing Address
First Line	:	133 N LINDEN ST
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-2626
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1061 N BROADWAY
Second Line	:
City	:	N MASSAPEQUA
State	:	NY
Zip	:	11758-1802
Country	:	US
Telephone Number	:	516-454-6387
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	07/08/2007

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