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General NPI Number Information
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NPI Number | 1386692887
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Entity Type | Individual
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Provider Name | DANA JAHN MS PT
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Gender | Female
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 06/17/2019
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Provider Practice Location Address
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Address Line | 3075 VETERANS MEMORIAL HWY STE 101
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City | RONKONKOMA
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State | NY
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Zip | 11779
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Country | US
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Telephone | 631-805-2850
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Fax | 631-670-6475
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Provider Business Mailing Address
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Address Line | 88 GANNET DR
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City | COMMACK
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State | NY
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Zip | 11725-4929
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Country | US
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Telephone | 631-360-9075
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Fax | 631-543-2283
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 010122-1
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License Number State | NY
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