Jennifer Murray Buonocore, MS, OTR/L
Individual provider Active NPI Contractor · Long Beach, NY
NPI 1063666865 · NPPES record last updated Jun 13, 2012
Key facts
- NPI
- 1063666865
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 011735-1 (NY)
- Practice address
- 310 National Blvd
Long Beach, NY 11561-3326 - Phone
- (516) 431-2929
- Fax
- (516) 431-6278
- NPI assigned
- Nov 6, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011735-1 | NY | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barry & Florence Friedberg JCC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 011735-1 | NY | Yes |
Addresses
Primary practice location
310 National Blvd
Long Beach, NY 11561-3326
Mailing address
1259 Mara CT
Atlantic Beach, NY 11509-1635
Phone (516) 431-1688
Other providers in Long Beach, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.