Provider Demographics
NPI:1487717484
Name:KANE, JOANNE (PT)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:KANE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4927
Mailing Address - Country:US
Mailing Address - Phone:631-376-4109
Mailing Address - Fax:631-376-3618
Practice Address - Street 1:185 S 10TH ST
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-4505
Practice Address - Country:US
Practice Address - Phone:631-956-6080
Practice Address - Fax:631-956-6070
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026461-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist