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NPI Code Detail

MEDICARE: JENNIFER M TRICOMI P.T.

MEDICARE:   JENNIFER M TRICOMI  P.T.
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 Therapist031120NY

General Provider Information

NPI Number : 1639318934
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER M TRICOMI P.T.
Provider Business Mailing Address
First Line : 150 55TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-2559
Country : US
Telephone Number : 718-630-6875
Fax Number : 718-630-6279
Provider Business Practice Location Address
First Line : 5800 3RD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-3702
Country : US
Telephone Number : 718-630-6180
Fax Number : 718-630-7437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2009
Last Update Date : 02/05/2015

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Directions to “ JENNIFER M TRICOMI P.T.” Practice Location

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