MEDICARE: MS. JEANETTE MAYR PT

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	225100000X	Physical Therapist	027787	NY

General Provider Information

NPI Number	:	1467412031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JEANETTE MAYR PT

Provider Business Mailing Address
First Line	:	148 E 48TH ST
Second Line	:	SUITE #1C
City	:	NEW YORK
State	:	NY
Zip	:	10017-1224
Country	:	US
Telephone Number	:	212-517-0020
Fax Number	:	212-517-4526

Provider Business Practice Location Address
First Line	:	148 E 48TH ST
Second Line	:	SUITE #1C
City	:	NEW YORK
State	:	NY
Zip	:	10017-1224
Country	:	US
Telephone Number	:	212-517-0020
Fax Number	:	212-517-4526

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

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	07/08/2007

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