Provider Demographics
NPI:1194857771
Name:LABELSON, JAN TODD (PT MS)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:TODD
Last Name:LABELSON
Suffix:
Gender:M
Credentials:PT MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W END AVE
Mailing Address - Street 2:APT. 29 H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5702
Mailing Address - Country:US
Mailing Address - Phone:212-580-2894
Mailing Address - Fax:212-580-2894
Practice Address - Street 1:150 W END AVE
Practice Address - Street 2:APT. 29 H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5702
Practice Address - Country:US
Practice Address - Phone:212-580-2894
Practice Address - Fax:212-580-2894
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019754225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist