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NPI Code Detail

MEDICARE: JACQUELINE ANN STEM

MEDICARE: JACQUELINE ANN STEM
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
1225200000XPhysical Therapy AssistantTEI001920PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1TEI001920OTHERPACOMMONWEALTH OF PA

General Provider Information

NPI Number : 1831757178
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE ANN STEM
Provider Business Mailing Address
First Line : 9 N MIDLAND AVE
Second Line :
City : EAGLEVILLE
State : PA
Zip : 19403-1263
Country : US
Telephone Number : 215-301-0737
Fax Number :
Provider Business Practice Location Address
First Line : 205 E JOHNSON HWY
Second Line :
City : NORRISTOWN
State : PA
Zip : 19401-2041
Country : US
Telephone Number : 610-275-6410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2019
Last Update Date : 06/02/2019

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