Provider Demographics
NPI:1255385373
Name:HAHN, JODY ANN (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:JODY
Middle Name:ANN
Last Name:HAHN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:JODY
Other - Middle Name:ANN
Other - Last Name:SAYLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:42 E LAUREL RD
Mailing Address - Street 2:UDP #1700
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1354
Mailing Address - Country:US
Mailing Address - Phone:856-566-7010
Mailing Address - Fax:856-566-6956
Practice Address - Street 1:42 E LAUREL RD
Practice Address - Street 2:UDP 1700
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1354
Practice Address - Country:US
Practice Address - Phone:856-566-7010
Practice Address - Fax:856-566-6956
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01021800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ120480C60Medicare PIN