Jasper Espigadera Jimenez, PTA
Physical Therapy Assistant in Farmingville, NY. Individual provider (NPI-1).
NPI number1164028619
StatusActive
Last updated in NPPESDec 9, 2020
Details
- NPI
- 1164028619
- Entity type
- Individual (NPI-1)
- Name
- Jasper Espigadera Jimenez
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 9, 2020
- Certification date
- Dec 9, 2020
- Last updated
- Dec 9, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | – | – | Yes |
Practice location
1008 Old Medford AveFarmingville, NY 11738-2830
Phone 347-606-6613
Mailing address
1008 Old Medford AveFarmingville, NY 11738-2830
Phone 347-606-6613
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