Most Relevant Information
Provider Data
| NPI Number: | 1003686072 |
| Provider Name: | JACOB MIRER PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 013990 |
Most Important Dates
| Enumeration Date: | 01/02/2024 |
| Last Updated: | 01/02/2024 |
Provider Practice Location
46 COOK ST
BROOKLYN
NY
112064004
Practice Location Phone/Fax
| Phone: | 7187017300 |
| Fax: |
Provider Mailing Location
46 COOK ST
BROOKLYN
NY
112064004
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |