Provider Demographics
NPI:1750307799
Name:DRUKIN, JESSICA M (MS PT)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:M
Last Name:DRUKIN
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:M
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS PT
Mailing Address - Street 1:501 WASHINGTON AVE
Mailing Address - Street 2:PLEASANTVILLE PHYSICAL THERAPY AND SPORTS CARE
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570
Mailing Address - Country:US
Mailing Address - Phone:914-741-2767
Mailing Address - Fax:914-741-2776
Practice Address - Street 1:501 WASHINGTON AVE
Practice Address - Street 2:PLEASANTVILLE PHYSICAL THERAPY AND SPORTS CARE
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570
Practice Address - Country:US
Practice Address - Phone:914-741-2767
Practice Address - Fax:914-741-2776
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006895225100000X
NY0202341225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTANC866OtherOXFORD ORTHONET NUMBER
CT080006895CT01OtherBCBS PROVIDER NUMBER
CT080006895CT01OtherBCBS PROVIDER NUMBER