Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JEREMY PETER MANG
ActiveJEREMY PETER MANG is a Physical Therapy Assistant healthcare provider located in GASPORT, New York. NPI 1881290740 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · GASPORT, NY
Registration Details
- NPI Number
- 1881290740
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 7, 2020 (5.6872807071926 yrs)
- Last Updated
- Dec 7, 2020
- License
-
022542-1 (NY)
Practice Information
- Address
-
4540 LINCOLN DRGASPORT, NY, 140679212Browse NY providers · Browse ZIP 14067
- Phone
- 7167722631
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.