National Provider Identifier
Jeremy Jensen Vanduluitgaarden
Jeremy Jensen Vanduluitgaarden is listed in the NPPES registry with a primary specialty of Orthopedic Physical Therapist in Lockport, NY and a listed phone number of (716) 282-2888.
Profile Overview
- NPI
- 1548924061
- Provider Type
- Individual
- Primary Specialty
- Orthopedic Physical Therapist
- Enumeration Date
- October 30, 2021
- Last Updated
- October 30, 2021
Practice Location
- 6000 Brockton Dr
- Lockport, NY 14094-9273
Phone: (716) 282-2888
Mailing Address
- 4503 Stoney Brook RD
- Oneida, NY 13421-3715
Specialties
- Orthopedic Physical Therapist (2251X0800X)
Full Record
- NPI
- 1548924061
- Entity Type
- Individual
- Last Name
- Vanduluitgaarden
- First Name
- Jeremy
- Middle Name
- Jensen
- Name Prefix
- Dr.
- Mailing Street Address
- 4503 Stoney Brook RD
- Mailing City
- Oneida
- Mailing State
- NY
- Mailing ZIP Code
- 13421-3715
- Mailing Country
- US
- Mailing Phone
- (315) 762-3533
- Practice Street Address
- 6000 Brockton Dr
- Practice City
- Lockport
- Practice State
- NY
- Practice ZIP Code
- 14094-9273
- Practice Country
- US
- Practice Phone
- (716) 282-2888
- Enumeration Date
- October 30, 2021
- Last Updated
- October 30, 2021
- Sex
- Male
- Sole Proprietor
- Yes
- Taxonomy Group 1
- 193400000X Multiple Single Specialty Group
- Certification Date
- October 29, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Orthopedic Physical Therapist (2251X0800X)