Doctor Name: | MR. JEROME A. SAN JOSE |
NPI Number: | 1366620569 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 027253-1 |
Business Practice Address: | 4150 78th St Apt. 514 Elmhurst, NY - 113731950 |
Business Phone Number: | 3476058285 |
Business Fax Number: | |
Mailing Address: | 4150 78th St, Apt. 514 ELMHURST |
State: | NY |
Postal Code: | 113731950 |
Phone Number: | 3476058285 |
Fax Number: | |
NPI Enumeration Date: | 02/11/2008 |
NPI Last Update Date: | 11/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 027253-1 |
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 |