Provider Demographics
NPI:1306263462
Name:NUNEZ, JOHN L (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:NUNEZ
Suffix:
Gender:M
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 1:258 TITUSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-3248
Mailing Address - Country:US
Mailing Address - Phone:845-475-8769
Mailing Address - Fax:845-746-2298
Practice Address - Street 1:258 TITUSVILLE RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-3248
Practice Address - Country:US
Practice Address - Phone:845-475-8769
Practice Address - Fax:845-746-2298
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037385225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist