Provider Demographics
NPI:1194271049
Name:AUCOIN, JENNIFER (DPT)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:AUCOIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1377 MOTOR PKWY STE 307
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5258
Mailing Address - Country:US
Mailing Address - Phone:631-580-5200
Mailing Address - Fax:631-760-8306
Practice Address - Street 1:21 PEEKSKILL HOLLOW RD STE 201
Practice Address - Street 2:
Practice Address - City:PUTNAM VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10579-3254
Practice Address - Country:US
Practice Address - Phone:845-528-3133
Practice Address - Fax:845-528-0463
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294895225100000X
MA22590225100000X
NY045800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1053320325OtherGROUP NPI
CA294895OtherPHYSICAL THERAPY BOARD OF CALIFORNIA