Provider Demographics
NPI:1245575331
Name:RESCH BALKUNAS, JANET RESCH (PT)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:RESCH
Last Name:RESCH BALKUNAS
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 1:1275 PLEASANT RD
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-2640
Mailing Address - Country:US
Mailing Address - Phone:516-221-2349
Mailing Address - Fax:
Practice Address - Street 1:1275 PLEASANT RD
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-2640
Practice Address - Country:US
Practice Address - Phone:516-221-2349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0125122251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics