MEDICARE: JAY A TANOY 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	22562	NY

General Provider Information

NPI Number	:	1497004428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY A TANOY PT

Provider Business Mailing Address
First Line	:	520 BEACH 20TH ST
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-3622
Country	:	US
Telephone Number	:	718-327-5011
Fax Number	:	718-327-1156

Provider Business Practice Location Address
First Line	:	520 BEACH 20TH ST
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-3622
Country	:	US
Telephone Number	:	718-327-5011
Fax Number	:	718-327-1156

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

Provider Enumeration Date	:	09/06/2012
Last Update Date	:	09/06/2012

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Directions to “ JAY A TANOY PT” Practice Location

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