Doctor Name: | MRS. JENNIFER ANNE TISEO |
NPI Number: | 1013058965 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, PT |
License Number: | 0155221 |
Business Practice Address: | 1 Brandywine Dr Deer Park, NY - 117295721 |
Business Phone Number: | 6313920081 |
Business Fax Number: | |
Mailing Address: | 3 Summit Dr, SMITHTOWN |
State: | NY |
Postal Code: | 117875151 |
Phone Number: | 6317244643 |
Fax Number: | |
NPI Enumeration Date: | 02/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 0155221 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |