Individual
MRS. JESSICA LYNN SARGALIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
100 BRIDGE ST, BROADALBIN, NY 12025-2193
(518) 954-2645
(518) 954-2659
Mailing address
20 PINE ST, BROADALBIN, NY 12025-3128
(518) 954-2500
(518) 954-2509
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
022845-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01414337
—
NY
01
—
1538212907
BROADALBIN-PERTH CSD NPI NUMBER
NY
01
—
251300000X
BROADALBIN-PERTH CSD TAXONOMY NUMBER
—
Enumeration date
01/06/2012
Last updated
01/06/2012
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