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General NPI Number Information
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NPI Number | 1598055931
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Entity Type | Organization
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Legal Business Name | JASON A CAMPOPIANO PT PLLC
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 10/17/2011
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Provider Practice Location Address
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Address Line | 9 BROAD ST
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City | GLENS FALLS
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State | NY
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Zip | 12801-4301
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Country | US
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Telephone | 518-409-4288
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Fax | 518-409-4289
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Provider Business Mailing Address
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Address Line | PO BOX 3279
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City | GLENS FALLS
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State | NY
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Zip | 12801-7279
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Country | US
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Telephone | 518-409-4288
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. JASON A CAMPOPIANO
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Credential | PT
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Telephone | 518-409-4288
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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 | 025357
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License Number State | NY
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