Most Relevant Information
Provider Data
| NPI Number: | 1003242009 |
| Provider Name: | JESSICA S BENARDELLO PT, DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 036629 |
Most Important Dates
| Enumeration Date: | 09/23/2013 |
| Last Updated: | 09/23/2013 |
Provider Practice Location
3711 35TH AVE
SUITE 3C & 3G
ASTORIA
NY
111011524
Practice Location Phone/Fax
| Phone: | 7187067500 |
| Fax: |
Provider Mailing Location
3107 34TH AVE
ASTORIA
NY
111062641
Provider Mailing Phone/Fax
| Phone: | 7734563067 |
| Fax: |