Healthcare Provider Details

I. General information

NPI: 1114072139
Provider Name (Legal Business Name): DAWN H YABLONSKI P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 E JERICHO TPKE UNIT A
HUNTINGTON NY
11743-5453
US

IV. Provider business mailing address

1206 E JERICHO TPKE UNIT A
HUNTINGTON NY
11743-5453
US

V. Phone/Fax

Practice location:
  • Phone: 631-549-0749
  • Fax: 631-549-1562
Mailing address:
  • Phone: 631-549-0749
  • Fax: 631-549-1562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number007157-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: