Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | ||
N | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1033761382 |
---|---|
Provider Name | Jennifer Hajek |
First Address | East Northport, NY 11731-4519 |
Second Address | Commack, NY 11725-5009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2019 |
Last Update Date | 29/08/2019 |