Healthcare Provider Details

I. General information

NPI: 1194299248
Provider Name (Legal Business Name): JENNIFER WINEBERG ZEITLER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2019
Last Update Date: 05/07/2019
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 Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER WINEBERG ZEITLER
Title or Position: PHYSICIAN
Credential: MD
Phone: 814-653-8000