Healthcare Provider Details

I. General information

NPI: 1740601160
Provider Name (Legal Business Name): JEANNETTE ZUCKER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2014
Last Update Date: 01/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 E 41ST ST SUITE 402
NEW YORK NY
10017-6222
US

IV. Provider business mailing address

60 E 8TH ST APT 18B
NEW YORK NY
10003-6514
US

V. Phone/Fax

Practice location:
  • Phone: 917-620-4532
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number62 025104
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: