Healthcare Provider Details

I. General information

NPI: 1538386586
Provider Name (Legal Business Name): JENNIFER BRINN RT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 HICKORY RD SUITE 240
PLYMOUTH MEETING PA
19462-1047
US

IV. Provider business mailing address

210 BUCKHORN DR
WILLIAMSTOWN NJ
08094-8515
US

V. Phone/Fax

Practice location:
  • Phone: 610-834-1122
  • Fax:
Mailing address:
  • Phone: 856-881-6002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number43ZA00371200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: