| Doctor Name: | MRS. JACQUELINE ASHLEY BRUNELL |
| NPI Number: | 1174760755 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, DPT |
| License Number: | 031023-1 |
| Business Practice Address: | 3506 James St Shrub Oak, NY - 105881916 |
| Business Phone Number: | 6312412727 |
| Business Fax Number: | |
| Mailing Address: | 3506 James St, SHRUB OAK |
| State: | NY |
| Postal Code: | 105881916 |
| Phone Number: | 6312412727 |
| Fax Number: | |
| NPI Enumeration Date: | 01/19/2009 |
| NPI Last Update Date: | 03/16/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 031023-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |