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General NPI Number Information
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NPI Number | 1871003012
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Entity Type | Organization
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Legal Business Name | JARED CASPE PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 10/02/2017
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Last Update Date | 10/02/2017
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Provider Practice Location Address
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Address Line | 25 TRUVAL LN
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City | NESCONSET
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State | NY
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Zip | 11767-2228
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Country | US
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Telephone | 516-680-1640
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Fax |
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Provider Business Mailing Address
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Address Line | 25 TRUVAL LN
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City | NESCONSET
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State | NY
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Zip | 11767-2228
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Country | US
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Telephone | 516-680-1640
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MR. JARED CASPE
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Credential | DPT
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Telephone | 516-680-1640
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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 | 027959-1
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License Number State | NY
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