Jennifer Brink, MS PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

026033-1 Issued in NY

Practice address

420 Gaffney Dr
Watertown, NY 13601-1823

Phone

(315) 788-2730

Fax

(315) 362-5303

NPI assigned

Jan 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Jennifer O'Lear Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083764864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 WEALTHA AVE APT 656D",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136015809",
            "telephone_number": "315-786-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 GAFFNEY DR",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011823",
            "telephone_number": "315-788-2730",
            "fax_number": "315-362-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINK",
        "first_name": "JENNIFER",
        "credential": "MS PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026033-1",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "3501009591",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "O'LEAR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Candace Breland, OTR/L
• Kevin Francis Brennan, FNP-C
• Fred J Bresler
• Danielle Brett, LMSW
• Jessica Brimmer, MC CCC SLP
• Ariana Brooks-James
• Lorraine Greene Brosemer, OTR
• Craig Michael Brower, PSY D
• Barbara Brown
• Brian R Brown, CRNA

• Physical Therapist in Watertown, NY
• Providers in Watertown, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.