Healthcare Provider Details

I. General information

NPI: 1316160591
Provider Name (Legal Business Name): CHRISTOPHER JADA PT,MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 BELMONT AVE
SCHENECTADY NY
12308-2104
US

IV. Provider business mailing address

35 HARRISON AVE
DELMAR NY
12054-3401
US

V. Phone/Fax

Practice location:
  • Phone: 518-382-4530
  • Fax: 518-382-4531
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number022176-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: