MEDICARE: DONNA JENKINS PT

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
1	225100000X	Physical Therapist	025029	NY

General Provider Information

NPI Number	:	1700187010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA JENKINS PT

Provider Business Mailing Address
First Line	:	9 VILLA DR
Second Line	:
City	:	PEEKSKILL
State	:	NY
Zip	:	10566-4933
Country	:	US
Telephone Number	:	914-382-4421
Fax Number	:

Provider Business Practice Location Address
First Line	:	149 NORTH ST
Second Line	:
City	:	CORTLANDT MANOR
State	:	NY
Zip	:	10567-1638
Country	:	US
Telephone Number	:	914-382-4421
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2010
Last Update Date	:	11/19/2023

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