Provider Demographics
NPI:1336466507
Name:ALTMAN, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:ALTMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1656 E 12TH ST
Mailing Address - Street 2:2ND FL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1012
Mailing Address - Country:US
Mailing Address - Phone:718-998-3020
Mailing Address - Fax:718-998-9059
Practice Address - Street 1:16204 JAMAICA AVE
Practice Address - Street 2:5TH FL
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4917
Practice Address - Country:US
Practice Address - Phone:718-206-4420
Practice Address - Fax:718-998-9059
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016138-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist