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NPI Code Detail

MEDICARE: JANE DEMONTEVERDE

MEDICARE: JANE DEMONTEVERDE
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 Therapist030176-1NY

General Provider Information

NPI Number : 1679855241
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE DEMONTEVERDE
Provider Business Mailing Address
First Line : 3304 WATERBURY AVE
Second Line :
City : BRONX
State : NY
Zip : 10465-1554
Country : US
Telephone Number : 718-931-3000
Fax Number : 718-514-8228
Provider Business Practice Location Address
First Line : 3304 WATERBURY AVE
Second Line :
City : BRONX
State : NY
Zip : 10465-1554
Country : US
Telephone Number : 718-931-3000
Fax Number : 718-514-8228
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2011
Last Update Date : 11/17/2011

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