Healthcare Provider Details

I. General information

NPI: 1124042270
Provider Name (Legal Business Name): JENNIFER WINEBERG ZEITLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 01/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 E MAIN ST
REYNOLDSVILLE PA
15851-1328
US

IV. Provider business mailing address

522 E MAIN ST
REYNOLDSVILLE PA
15851-1328
US

V. Phone/Fax

Practice location:
  • Phone: 814-653-8000
  • Fax: 814-653-9632
Mailing address:
  • Phone: 814-653-8000
  • Fax: 814-653-9632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD063282L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: