MEDICARE: MRS. JENNIFER ORECCHIO PTA

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
1	225200000X	Physical Therapy Assistant	TEI001475	PA

General Provider Information

NPI Number	:	1598123804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER ORECCHIO PTA

Provider Business Mailing Address
First Line	:	1314 SANDSTONE DR
Second Line	:
City	:	MC DONALD
State	:	PA
Zip	:	15057-2592
Country	:	US
Telephone Number	:	412-926-8941
Fax Number	:

Provider Business Practice Location Address
First Line	:	249 W MCMURRAY RD
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-2468
Country	:	US
Telephone Number	:	800-243-4556
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2016
Last Update Date	:	02/01/2016

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