Provider Demographics
NPI:1386692887
Name:JAHN, DANA (MS PT)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:JAHN
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
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Mailing Address - Street 1:88 GANNET DR
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-4929
Mailing Address - Country:US
Mailing Address - Phone:631-360-9075
Mailing Address - Fax:631-543-2283
Practice Address - Street 1:3075 VETERANS MEMORIAL HWY STE 101
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779
Practice Address - Country:US
Practice Address - Phone:631-805-2850
Practice Address - Fax:631-670-6475
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2019-06-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY010122-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY20406POtherHIP
NY0009552OtherGHI
NYP575326OtherOXFORD
NY02019249Medicaid
NYP01191008OtherRAIL ROAD MEDICARE
NY107548801OtherPOSTAL WORKERS COMPENSATION
NYAZ00717OtherMDNY HEALTHCARE
NYP575326OtherOXFORD