Provider Demographics
NPI:1881849776
Name:BECKERMAN, JANA WENDI (PT)
Entity Type:Individual
Prefix:MRS
First Name:JANA
Middle Name:WENDI
Last Name:BECKERMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3342 MURDOCK AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-3626
Mailing Address - Country:US
Mailing Address - Phone:516-536-7447
Mailing Address - Fax:
Practice Address - Street 1:3342 MURDOCK AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-3626
Practice Address - Country:US
Practice Address - Phone:516-536-7447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022449-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics