Healthcare Provider Details

I. General information

NPI: 1669713731
Provider Name (Legal Business Name): ERIN MARIE JANOVER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2013
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 SULLIVAN ST
BROOKLYN NY
11231-1600
US

IV. Provider business mailing address

250 BEACH 118TH ST
ROCKAWAY PARK NY
11694-2037
US

V. Phone/Fax

Practice location:
  • Phone: 718-330-9280
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number036172-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: