Jason Harvey, PTA

Individual provider Active NPI Physical Therapy Assistant · East Quogue, NY

NPI 1215487541 · NPPES record last updated Oct 11, 2016

Key facts

NPI
1215487541
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
Practice address
143 Chardonnay Dr
East Quogue, NY 11942-3829
Phone
(631) 278-0665
Fax
(631) 619-6680
NPI assigned
Oct 11, 2016
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X CT Yes

Addresses

Primary practice location

143 Chardonnay Dr
East Quogue, NY 11942-3829

Mailing address

13 Hillside Rd
Southbury, CT 06488-2024

Other providers in East Quogue, NY

All providers in East Quogue, NY · Physical Therapy Assistant in New York

Sources for this page

Verify at the official NPI Registry.