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NPI Code Detail

MEDICARE: JODI ANN LOV PT

MEDICARE: JODI ANN LOV 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
1225100000XPhysical Therapist023953-1NY

General Provider Information

NPI Number : 1720253834
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODI ANN LOV PT
Provider Business Mailing Address
First Line : 389 FORT SALONGA RD
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-3044
Country : US
Telephone Number : 631-261-0444
Fax Number : 631-261-3112
Provider Business Practice Location Address
First Line : 389 FORT SALONGA RD
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-3044
Country : US
Telephone Number : 631-261-0444
Fax Number : 631-261-3112
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2008
Last Update Date : 04/29/2008

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Directions to “ JODI ANN LOV PT” Practice Location

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