| Doctor Name: | DR. JEROLD BLATT |
| NPI Number: | 1992971097 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DC PT |
| License Number: | 6047 |
| Business Practice Address: | 18417 Union Tpke Fresh Meadows, NY - 113661729 |
| Business Phone Number: | 7184540737 |
| Business Fax Number: | 7184541819 |
| Mailing Address: | 18417 Union Turnpike, FRESH MEADOWS |
| State: | NY |
| Postal Code: | 11366 |
| Phone Number: | 7184540737 |
| Fax Number: | 7184541819 |
| NPI Enumeration Date: | 05/08/2008 |
| NPI Last Update Date: | 09/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 6047 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| 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 |