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General NPI Number Information
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NPI Number | 1982583555
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Entity Type | Individual
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Provider Name | JENNIFER MIRDITA
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Gender | Female
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 16 N GREENBUSH RD
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City | TROY
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State | NY
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Zip | 12180-8579
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Country | US
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Telephone | 914-310-6668
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Fax | 518-326-3771
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Provider Business Mailing Address
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Address Line | 16 N GREENBUSH RD
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City | TROY
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State | NY
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Zip | 12180-8579
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Country | US
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Telephone | 518-326-3771
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 041842
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License Number State | NY
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