Provider Demographics
NPI:1275658338
Name:WEISBLATT, JONATHAN SIMEON (PT)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:SIMEON
Last Name:WEISBLATT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 LAKEWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645
Mailing Address - Country:US
Mailing Address - Phone:508-430-1660
Mailing Address - Fax:
Practice Address - Street 1:130 NORTH ST
Practice Address - Street 2:CAPE COD HOSPITAL REHABILITATION SERVICES
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-771-9600
Practice Address - Fax:508-775-1753
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10428225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist