Provider Demographics
NPI:1619033297
Name:SHILOFF, JENNIFER DAWN (DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DAWN
Last Name:SHILOFF
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 1:340 E 80TH ST
Mailing Address - Street 2:APT 2H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0927
Mailing Address - Country:US
Mailing Address - Phone:732-991-7766
Mailing Address - Fax:
Practice Address - Street 1:320 E 65TH ST
Practice Address - Street 2:SUITE 117
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6743
Practice Address - Country:US
Practice Address - Phone:212-249-2588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024207-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist