Active NPI
Jenny Garneau
- Physical Therapist
- Latham, NY
National Provider Identifier
1851409031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 019819-1
- Practice address
- 711 Troy Schenectady Rd
Suite 214
Latham, NY 12110-2442 - Phone
- (518) 690-2882
- Fax
- (518) 690-2884
- NPI assigned
- Aug 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 019819-1 | NY | Primary |
Addresses
Primary practice location
711 Troy Schenectady Rd
Suite 214
Latham, NY 12110-2442
Mailing address
711 Troy Schenectady Rd
Suite 209
Latham, NY 12110-2442
Phone (518) 786-1667
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 650021313 | Other | NY | RR MEDICARE |
| PT19707 | Other | FL | LICENSE # |
| PT19819-1 | Other | NY | LICENSE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019819-1 | NY | MD | Speech-Language Pathologist |
| 019819 | NY | MD | Physician Assistant |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257724800000",
"number": "1851409031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 TROY SCHENECTADY RD",
"address_2": "SUITE 209",
"city": "LATHAM",
"state": "NY",
"postal_code": "121102442",
"telephone_number": "518-786-1667",
"fax_number": "518-786-1954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 TROY SCHENECTADY RD",
"address_2": "SUITE 214",
"city": "LATHAM",
"state": "NY",
"postal_code": "121102442",
"telephone_number": "518-690-2882",
"fax_number": "518-690-2884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARNEAU",
"first_name": "JENNY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-28",
"last_updated": "2009-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "019819-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "650021313",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "PT19707",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "PT19819-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Latham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.