Provider Demographics
NPI:1841482114
Name:MONAHAN, JENNIFER ANNE (MS PT)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANNE
Last Name:MONAHAN
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:ANNE
Other - Last Name:BARTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS PT
Mailing Address - Street 1:4353 HYLAN BLVD
Mailing Address - Street 2:DEVITA BECKER PHYSICAL THERAPY PC
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312
Mailing Address - Country:US
Mailing Address - Phone:718-967-3363
Mailing Address - Fax:718-967-5437
Practice Address - Street 1:4353 HYLAN BLVD
Practice Address - Street 2:DEVITA BECKER PHYSICAL THERAPY PC
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312
Practice Address - Country:US
Practice Address - Phone:718-967-3363
Practice Address - Fax:718-967-5437
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0270811225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist