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NPI Code Detail

MEDICARE: MR. AARON W JORDAN P.T.A

MEDICARE: MR. AARON W JORDAN P.T.A
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
1225200000XPhysical Therapy Assistant005283-1NY

General Provider Information

NPI Number : 1174738066
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. AARON W JORDAN P.T.A
Provider Business Mailing Address
First Line : 3073 BUHRE AVE APT 5G
Second Line :
City : BRONX
State : NY
Zip : 10461-4737
Country : US
Telephone Number : 718-239-2482
Fax Number :
Provider Business Practice Location Address
First Line : 2000 E GUN HILL RD
Second Line :
City : BRONX
State : NY
Zip : 10469-6016
Country : US
Telephone Number : 718-405-3542
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2007
Last Update Date : 07/08/2007

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