Healthcare Provider Details

I. General information

NPI: 1174996680
Provider Name (Legal Business Name): JENNIFER A GUGLIELMI MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2015
Last Update Date: 11/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W STATE ST STE 103
DOYLESTOWN PA
18901-2250
US

IV. Provider business mailing address

800 W STATE ST STE 103
DOYLESTOWN PA
18901-2250
US

V. Phone/Fax

Practice location:
  • Phone: 267-241-4010
  • Fax:
Mailing address:
  • Phone: 267-241-4010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number77860501
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: