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Organization
JWG PHYSICAL THERAPY PC
Active
Organization
JWG PHYSICAL THERAPY PC
Active
Other names
Gardiner Physical Therapy Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN WILLIAM GARDINER P.T. (EXECUTIVE DIRECTOR)
(516) 656-4824
Entity
Organization
Contact information
Practice address
1 SCHOOL ST, SUITE 105A, GLEN COVE, NY 11542-2545
(516) 656-4824
(516) 656-4833
Mailing address
1 SCHOOL ST, SUITE 105A, GLEN COVE, NY 11542-2545
(516) 656-4824
(516) 656-4833
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5249
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0026201
CIGNA
NY
01
—
100206834602
UNITED HEALTHCARE-MEDICAI
NY
01
—
136840
VYTRA PROVIDER NUMBER
NY
01
—
273729
1199 PROVIDER NUMBER
NY
01
—
2904019
AETNA PPO PROVIDER NUMBER
NY
01
—
58958P
HIP PROVIDER NUMBER
NY
01
—
5C7048
HEALTHNET PROVIDER NUMBER
NY
01
—
600934000
DEPARTMENT OF LABOR
—
01
—
6605247
GHI PROVIDER NUMBER
NY
01
—
7004397
AETNA HMO PROVIDER NUMBER
NY
01
—
P2720801
OXFORD PROVIDER NUMBER
NY
01
—
QN6301
EMPIRE PROVIDER NUMBER
NY
Enumeration date
07/26/2007
Last updated
06/21/2018
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