Provider Demographics
NPI:1003065434
Name:MASHAW, JENNIFER SZYMANSKI (PT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SZYMANSKI
Last Name:MASHAW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 FOXHOUND RUN
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-5784
Mailing Address - Country:US
Mailing Address - Phone:585-259-7933
Mailing Address - Fax:
Practice Address - Street 1:5 FOXHOUND RUN
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-5784
Practice Address - Country:US
Practice Address - Phone:585-259-7933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028333-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist