Healthcare Provider Details

I. General information

NPI: 1922219831
Provider Name (Legal Business Name): JANET RUQUET PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CHAPEL PL
EAST PATCHOGUE NY
11772-5711
US

IV. Provider business mailing address

7 CHAPEL PL
EAST PATCHOGUE NY
11772-5711
US

V. Phone/Fax

Practice location:
  • Phone: 631-730-7752
  • Fax:
Mailing address:
  • Phone: 631-730-7752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number009428-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: