Provider Demographics
NPI:1912091042
Name:DAVAN, JOAN A (PT)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:A
Last Name:DAVAN
Suffix:
Gender:F
Credentials:PT
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 RYE RIDGE PLAZA
Mailing Address - Street 2:SUITE 219 PHYSICAL THERAPY GROUP OF WESTCHESTER PC
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573
Mailing Address - Country:US
Mailing Address - Phone:914-253-6457
Mailing Address - Fax:914-253-6458
Practice Address - Street 1:10 RYE RIDGE PLAZA
Practice Address - Street 2:SUITE 219 PHYSICAL THERAPY GROUP OF WESTCHESTER PC
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573
Practice Address - Country:US
Practice Address - Phone:914-253-6457
Practice Address - Fax:914-253-6458
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY003835225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQP4191Medicare PIN