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General NPI Number Information
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NPI Number | 1144557109
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Entity Type | Organization
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Legal Business Name | TJD PHYSICAL THERAPY CONSULTANT PC
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Dates
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Enumeration Date | 11/12/2009
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Last Update Date | 11/12/2009
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Provider Practice Location Address
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Address Line | 25 PLITT AVE
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City | FARMINGDALE
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State | NY
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Zip | 11735-5104
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Country | US
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Telephone | 516-353-5485
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Fax | 516-454-6991
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Provider Business Mailing Address
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Address Line | 25 PLITT AVE
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City | FARMINGDALE
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State | NY
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Zip | 11735-5104
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Country | US
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Telephone | 516-353-5485
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Fax | 516-454-6991
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. TIMOTHY BRIAN JONES
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Credential | P.T
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Telephone | 516-454-6991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 007240
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License Number State | NY
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