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Individual

MS. JGERTELLE S PAYNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
21 CONKLIN AVE, BROOKLYN, NY 11236-3625
(321) 263-1344
Mailing address
21 CONKLIN AVE, BROOKLYN, NY 11236-3625
(321) 262-1344

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
008341-1
NY
208100000X
Physical Medicine & Rehabilitation Physician
0083411
NY
225200000X
Physical Therapy Assistant
Primary
008341-1
NY
225200000X
Physical Therapy Assistant
0083411
NY

Other

Enumeration date
07/12/2017
Last updated
07/12/2017
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