Provider Demographics
NPI:1275831778
Name:ELIOWITZ, JASON R (PT, DPT, CSCS)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:R
Last Name:ELIOWITZ
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 INDUSTRIAL RD STE 210
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-2801
Mailing Address - Country:US
Mailing Address - Phone:302-449-6475
Mailing Address - Fax:
Practice Address - Street 1:20268 PLANTATIONS RD STE B
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4622
Practice Address - Country:US
Practice Address - Phone:302-449-6475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033145225100000X
NJ40QA01436200225100000X
DEJ1-0003839225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist