Provider Demographics
NPI:1609009950
Name:PUNZONE, JONATHAN (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:PUNZONE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 SUNRISE HWY
Mailing Address - Street 2:DR. JEFF SILBER
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-5311
Mailing Address - Country:US
Mailing Address - Phone:516-541-1064
Mailing Address - Fax:516-798-9070
Practice Address - Street 1:4200 SUNRISE HWY
Practice Address - Street 2:DR. JEFF SILBER
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5311
Practice Address - Country:US
Practice Address - Phone:516-541-1064
Practice Address - Fax:516-798-9070
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031338225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist