Jennifer Ann Nizer, MSPT
Individual provider Active NPI Specialist · Troy, NY
NPI 1346493848 · NPPES record last updated Mar 10, 2013
Key facts
- NPI
- 1346493848
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 022134-1 (NY)
- Practice address
- 12 Kerry Dr
Troy, NY 12180-6128 - Phone
- (518) 326-1174
- NPI assigned
- Oct 28, 2008
- Sex
- Female
- Sole proprietor
- No
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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022134-1 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia Physical Therapy PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 022134-1 | NY | Yes |
Addresses
Primary practice location
12 Kerry Dr
Troy, NY 12180-6128
Mailing address
12 Kerry Dr
Troy, NY 12180-6128
Phone (518) 326-1174
Other providers in Troy, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2013. 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.