Provider Demographics
NPI:1033477336
Name:FOODY, JANE
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:FOODY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 ROUTE 312
Mailing Address - Street 2:SUITE 301B
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-2377
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:185 ROUTE 312
Practice Address - Street 2:SUITE 301B
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-2337
Practice Address - Country:US
Practice Address - Phone:845-279-9288
Practice Address - Fax:845-279-7701
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034956225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist