=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942582770
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JENNIFER AULETA PHYSICAL THERAPY P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2011
-----------------------------------------------------
Last Update Date | 04/19/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 111 THOMAS PL
-----------------------------------------------------
City | N BELLMORE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11710-2807
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-314-6984
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 111 THOMAS PL
-----------------------------------------------------
City | N BELLMORE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11710-2807
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-314-6984
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JENNIFER AULETA
-----------------------------------------------------
Credential | PT, DPT
-----------------------------------------------------
Telephone | 516-314-6984
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number | 032046
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------