Provider Demographics
NPI:1952948986
Name:BUDETTI, JORDANNA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JORDANNA
Middle Name:
Last Name:BUDETTI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 LAKE DR
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-2418
Mailing Address - Country:US
Mailing Address - Phone:914-277-7331
Mailing Address - Fax:
Practice Address - Street 1:73 MARKET ST STE 178A
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-7618
Practice Address - Country:US
Practice Address - Phone:914-597-2882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11305225100000X
NY038074225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist