Provider Demographics
NPI:1184811218
Name:TAITANO, JOCELYN MONES (PT,)
Entity type:Individual
Prefix:MRS
First Name:JOCELYN
Middle Name:MONES
Last Name:TAITANO
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 1:2728 KINGS HWY
Mailing Address - Street 2:A-1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1768
Mailing Address - Country:US
Mailing Address - Phone:718-306-2980
Mailing Address - Fax:718-763-0545
Practice Address - Street 1:2728 KINGS HWY
Practice Address - Street 2:A-1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1768
Practice Address - Country:US
Practice Address - Phone:718-306-2980
Practice Address - Fax:718-763-0545
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013196225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist