Basic Information
Provider Information
NPI: 1477984789
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JUREWICZ
FirstName: JENNIFER
MiddleName:  
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Credential:  
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Mailing Information
Address1: 1536 3RD AVE
Address2: 5TH FLOOR
City: NEW YORK
State: NY
PostalCode: 100282167
CountryCode: US
TelephoneNumber: 2128612630
FaxNumber: 2128612685
Practice Location
Address1: 170 E 77TH ST
Address2: SUITE#2
City: NEW YORK
State: NY
PostalCode: 100751912
CountryCode: US
TelephoneNumber: 2122495332
FaxNumber: 2122499539
Other Information
ProviderEnumerationDate: 12/12/2013
LastUpdateDate: 11/26/2014
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X037126NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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