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NPI Code Detail

MEDICARE: MISS JESSICA L. IZYK PT, DPT

MEDICARE: MISS JESSICA L. IZYK PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT26756FL
2225100000XPhysical Therapist033853NY

General Provider Information

NPI Number : 1114261088
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JESSICA L. IZYK PT, DPT
Provider Business Mailing Address
First Line : 20 PEACHTREE CT STE 105
Second Line :
City : HOLBROOK
State : NY
Zip : 11741-4616
Country : US
Telephone Number : 631-467-3700
Fax Number : 631-467-0928
Provider Business Practice Location Address
First Line : 2480 N PARK RD
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-3744
Country : US
Telephone Number : 954-981-0584
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2012
Last Update Date : 02/07/2020

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