MEDICARE: MS. JUDITH TABER 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	013254-1	NY

General Provider Information

NPI Number	:	1487669198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUDITH TABER P.T.

Provider Business Mailing Address
First Line	:	333 E 56TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-3758
Country	:	US
Telephone Number	:	212-317-1600
Fax Number	:	212-317-9855

Provider Business Practice Location Address
First Line	:	333 E 56TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-3758
Country	:	US
Telephone Number	:	212-317-1600
Fax Number	:	212-317-9855

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

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	07/08/2007

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