Jack Michael Panagrossi
Specialist/Technologist, Athletic Trainer in Brewster, NY. Individual provider (NPI-1).
NPI number1730985854
StatusActive
Last updated in NPPESFeb 20, 2025
Details
- NPI
- 1730985854
- Entity type
- Individual (NPI-1)
- Name
- Jack Michael Panagrossi
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 20, 2025
- Certification date
- Feb 20, 2025
- Last updated
- Feb 20, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
35 Salmons Hollow RdBrewster, NY 10509-5115
Phone 845-745-1341
Mailing address
35 Salmons Hollow RdBrewster, NY 10509-5115
Phone 845-745-1341
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