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General NPI Number Information
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NPI Number | 1730552217
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Entity Type | Individual
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Provider Name | JACLYN ROTHMAN PT
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Gender | Female
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Dates
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Enumeration Date | 11/05/2015
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Last Update Date | 07/01/2020
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Provider Practice Location Address
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Address Line | 430 E 34TH ST
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 646-929-7970
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Fax |
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Provider Business Mailing Address
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Address Line | 130 BLOOMFIELD ST APARTMENT 3
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City | HOBOKEN
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State | NJ
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Zip | 07030-4652
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Country | US
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Telephone | 732-766-9994
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 62 037434
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01543900
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License Number State | NJ
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