Provider Demographics
NPI:1538313275
Name:MEYER, NINA JACOBS (DPT)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:JACOBS
Last Name:MEYER
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 1:773 ADDISON ST
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2937
Mailing Address - Country:US
Mailing Address - Phone:516-295-4863
Mailing Address - Fax:
Practice Address - Street 1:773 ADDISON ST
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2937
Practice Address - Country:US
Practice Address - Phone:516-295-4863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017709-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics