Provider Demographics
NPI:1588935340
Name:REDMOND, JANE C (PTA, GCFP, EMT)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:C
Last Name:REDMOND
Suffix:
Gender:F
Credentials:PTA, GCFP, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2-8 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12095-2308
Mailing Address - Country:US
Mailing Address - Phone:518-762-8215
Mailing Address - Fax:518-762-2972
Practice Address - Street 1:2-8 W MAIN ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:NY
Practice Address - Zip Code:12095-2308
Practice Address - Country:US
Practice Address - Phone:518-762-8215
Practice Address - Fax:518-762-2972
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY377948146M00000X
NY000742-1222Q00000X, 225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist