Provider Demographics
NPI:1346552593
Name:CRAIG, JESSICA (DPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:CRAIG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 DOWNING ST
Mailing Address - Street 2:O.I.O.C.
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-4331
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:63 DOWNING ST
Practice Address - Street 2:O.I.O.C.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-4331
Practice Address - Country:US
Practice Address - Phone:212-255-6690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-04
Last Update Date:2010-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030880225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist