Provider Demographics
NPI:1942453659
Name:STECK, JAMIE BERRIER (MS,PT)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:BERRIER
Last Name:STECK
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LYNN
Other - Last Name:BERRIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,PT
Mailing Address - Street 1:21 DE LUCIA TER
Mailing Address - Street 2:
Mailing Address - City:LOUDONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12211-2005
Mailing Address - Country:US
Mailing Address - Phone:518-428-3790
Mailing Address - Fax:518-463-9166
Practice Address - Street 1:21 DE LUCIA TER
Practice Address - Street 2:
Practice Address - City:LOUDONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12211-2005
Practice Address - Country:US
Practice Address - Phone:518-428-3790
Practice Address - Fax:518-463-9166
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-25
Last Update Date:2008-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010521225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist