Provider Demographics
NPI:1487605119
Name:TUZZOLO, JODI ROBIN (DPT)
Entity type:Individual
Prefix:DR
First Name:JODI
Middle Name:ROBIN
Last Name:TUZZOLO
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 1:3814 HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2319
Mailing Address - Country:US
Mailing Address - Phone:516-221-8088
Mailing Address - Fax:
Practice Address - Street 1:2140 BELLMORE AVE
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-5662
Practice Address - Country:US
Practice Address - Phone:516-586-5533
Practice Address - Fax:516-586-5531
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025540-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ0WDP1Medicare PIN