Jackson, Denise Serotta

Jackson, Denise Serotta is an individual health care provider with primary practice located at Stephen W. Bassin, P.T., P.C. 32 Sherman Ave, Glen Falls NY 12801. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Jackson, Denise Serotta can be contacted via phone (518) 793-7136.

Contact Information

Primary practice address
Stephen W. Bassin, P.T., P.C. 32 Sherman Ave Glen Falls NY 12801
Phone: (518) 793-7136
Fax: (518) 793-7142
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 012831-1 New York

Profile Details

NPI number 1295732071
LBN Legal business name Jackson, Denise Serotta
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295732071 NPPES
New York Other 000499025001 BLUESHIELD OF NE NY
New York MEDICAID 01699036 BLUESHIELD OF NE NY
New York Other DJ0QL58710 BLUESHIELD OF NE NY

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