Janice D Congdon, P.T.

Individual provider Active NPI Physical Therapist · Jacksonville, NY

NPI 1508947144 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1508947144
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
004048-1 (NY)
Practice address
1859 Trumansburg Rd.
Jacksonville, NY 14854-0122
Phone
(607) 387-5729
Fax
(607) 387-5315
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
004048-1NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Beth I.Guthrie Physical Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 004048-1 NY Yes

Addresses

Primary practice location

1859 Trumansburg Rd.
Jacksonville, NY 14854-0122

Mailing address

1859 Trumansburg Rd.
PO Box 122
Jacksonville, NY 14854-0122
Phone (607) 387-5729

Other identifiers

IdentifierTypeStateIssuer
803886OtherNYACN GROUP

Other providers in Jacksonville, NY

All providers in Jacksonville, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.