Individual
MRS. JEANINE MARY HAKANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
410 PENDALE ST, STATEN ISLAND, NY 10306-4040
(917) 609-8094
Mailing address
410 PENDALE ST, STATEN ISLAND, NY 10306-4040
(917) 609-8094
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
017663
NY
Other
Enumeration date
05/14/2009
Last updated
07/25/2011
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