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Organization
JOSCELYN TRAVERS
Active
Organization
JOSCELYN TRAVERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JEAN GALLAGHER (ADMINISTRATIVE DIRECTOR)
(631) 665-4560
Entity
Organization
Contact information
Practice address
225 HOWELLS RD, BAY SHORE, NY 11706-5319
(631) 665-4560
Mailing address
225 HOWELLS RD, BAY SHORE, NY 11706-5319
(631) 665-4560
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0210001
AETNA NON-HMO
NY
05
—
027442703
—
NY
01
—
203121819
MPN
NY
01
—
61318
MVP
NY
01
—
GRP496389003
HEALTHNOW
NY
Enumeration date
10/26/2006
Last updated
03/25/2010
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