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General NPI Number Information
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NPI Number | 1467278291
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Entity Type | Individual
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Provider Name | JENNIFER ROCHE MSPT
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Gender | Female
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 8 W 36TH ST FL 5
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City | NEW YORK
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State | NY
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Zip | 10018-9776
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Country | US
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Telephone | 212-317-8303
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Fax |
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Provider Business Mailing Address
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Address Line | 290 W END AVE # 4A
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City | NEW YORK
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State | NY
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Zip | 10023-8106
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Country | US
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Telephone | 917-692-0797
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Fax |
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 016250
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License Number State | NY
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