Provider Demographics
NPI:1356812663
Name:REED, JARED (DPT)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:REED
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BARRY LN
Mailing Address - Street 2:
Mailing Address - City:SCOTIA
Mailing Address - State:NY
Mailing Address - Zip Code:12302-3802
Mailing Address - Country:US
Mailing Address - Phone:518-320-6746
Mailing Address - Fax:
Practice Address - Street 1:955 HARPERSVILLE RD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-1085
Practice Address - Country:US
Practice Address - Phone:757-223-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-13
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1386554225100000X
NY043916225100000X
VA2305217023225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY043916OtherLICENSE