Healthcare Provider Details

I. General information

NPI: 1063320778
Provider Name (Legal Business Name): JASMINE CHEVEZ PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 E 21ST ST
NEW YORK NY
10010-6212
US

IV. Provider business mailing address

77 ELM DR N
LEVITTOWN NY
11756-5503
US

V. Phone/Fax

Practice location:
  • Phone: 212-810-4120
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number052857-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: