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NPI Code Detail

MEDICARE: JILLIAN SEROWATKA

MEDICARE: JILLIAN SEROWATKA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1083016562
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILLIAN SEROWATKA
Provider Business Mailing Address
First Line : 8592 OLD LINE RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19128-1230
Country : US
Telephone Number : 267-879-9714
Fax Number :
Provider Business Practice Location Address
First Line : 3500 W CHESTER PIKE
Second Line :
City : NEWTOWN SQUARE
State : PA
Zip : 19073-4101
Country : US
Telephone Number : 610-359-4421
Fax Number : 610-353-4651
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2014
Last Update Date : 04/22/2019

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