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General NPI Number Information
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NPI Number | 1023053956
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Entity Type | Individual
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Provider Name | JANICE MARIE XENAKIS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 10/29/2009
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Provider Practice Location Address
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Address Line | 526 S RIVERSIDE DR
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City | NEPTUNE
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State | NJ
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Zip | 07753-5841
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Country | US
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Telephone | 908-461-1817
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Fax | 732-612-1298
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Provider Business Mailing Address
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Address Line | 526 S RIVERSIDE DR
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City | NEPTUNE
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State | NJ
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Zip | 07753-5841
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Country | US
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Telephone | 908-461-1817
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Fax | 732-612-1298
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 40QA00919000
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License Number State | NJ
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