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General NPI Number Information
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NPI Number | 1619860319
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Entity Type | Individual
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Provider Name | JILU JOHN PT
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Gender | Female
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Dates
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Enumeration Date | 05/31/2025
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Last Update Date | 05/31/2025
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Provider Practice Location Address
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Address Line | 246 JERICHO TPKE # NA
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City | FLORAL PARK
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State | NY
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Zip | 11001-2147
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Country | US
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Telephone | 516-531-7879
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Fax | 516-773-7315
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Provider Business Mailing Address
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Address Line | 928 N 1ST ST # NA
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-2822
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Country | US
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Telephone | 678-467-2578
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Fax | 516-555-1234
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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 | 053327
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License Number State | NY
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