Provider Demographics
NPI:1295726818
Name:DINGMAN, JANE W (PT)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:W
Last Name:DINGMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5075 SOUTH SHORE ROAD
Mailing Address - Street 2:POB 310
Mailing Address - City:THREE MILE BAY
Mailing Address - State:NY
Mailing Address - Zip Code:13693
Mailing Address - Country:US
Mailing Address - Phone:315-783-5426
Mailing Address - Fax:
Practice Address - Street 1:11050 MT BELVEDERE BLVD
Practice Address - Street 2:USA MEDDAC / CREDENTIALS
Practice Address - City:FORT DRUM
Practice Address - State:NY
Practice Address - Zip Code:13602-5004
Practice Address - Country:US
Practice Address - Phone:315-772-6214
Practice Address - Fax:315-774-4065
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY006092-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist