Provider Demographics
NPI:1023053956
Name:XENAKIS, JANICE MARIE (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:MARIE
Last Name:XENAKIS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:JANICE
Other - Middle Name:MARIE
Other - Last Name:AGLIETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:526 S RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-5841
Mailing Address - Country:US
Mailing Address - Phone:908-461-1817
Mailing Address - Fax:732-612-1298
Practice Address - Street 1:526 S RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-5841
Practice Address - Country:US
Practice Address - Phone:908-461-1817
Practice Address - Fax:732-612-1298
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA009190002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics