Jordan, Beth

Jordan, Beth is an individual health care provider with primary practice located at 219 County Route 57 Unit 20, Phoenix NY 13135-3300. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Jordan, Beth can be contacted via phone (315) 934-4459.

Contact Information

Primary practice address
219 County Route 57 Unit 20 Phoenix NY 13135-3300
Phone: (315) 934-4459
Fax: (315) 934-4459
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X 015186 New York

Profile Details

NPI number 1407091713
LBN Legal business name Jordan, Beth
Credentials OTD, MSOTR
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 16th, 2008
Last updated Mar 29th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407091713 NPPES
New York MEDICAID 03426868

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