Provider Demographics
NPI:1922362193
Name:YI, JAMIE NAMSU (PT)
Entity Type:Individual
Prefix:MR
First Name:JAMIE
Middle Name:NAMSU
Last Name:YI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:60 DUTCH HILL RD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-1723
Mailing Address - Country:US
Mailing Address - Phone:201-660-2485
Mailing Address - Fax:845-359-2095
Practice Address - Street 1:60 DUTCH HILL RD
Practice Address - Street 2:SUITE #2
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962-1723
Practice Address - Country:US
Practice Address - Phone:201-660-2485
Practice Address - Fax:845-359-2095
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017357225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist