Judith L Leib Annunziata, PT

Individual provider Active NPI Physical Therapist · N Merrick, NY

NPI 1114064847 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1114064847
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
005843-1 (NY)
Practice address
96 Winifred Dr
N Merrick, NY 11566-1725
Phone
(516) 378-1405
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
005843-1NYMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 005843-1 NY Yes

Addresses

Primary practice location

96 Winifred Dr
N Merrick, NY 11566-1725

Mailing address

96 Winifred Dr
N Merrick, NY 11566-1725
Phone (516) 378-1405

Other providers in N Merrick, NY

All providers in N Merrick, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.