Provider Demographics
NPI:1114685609
Name:SHLIMOUN, JOHN JUDE (DPT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:JUDE
Last Name:SHLIMOUN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WATCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-2534
Mailing Address - Country:US
Mailing Address - Phone:914-202-0700
Mailing Address - Fax:
Practice Address - Street 1:7 WATCH HILL RD
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-2534
Practice Address - Country:US
Practice Address - Phone:914-202-0700
Practice Address - Fax:914-462-3444
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
048191225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist