Healthcare Provider Details

I. General information

NPI: 1558727230
Provider Name (Legal Business Name): JENNIFER JOAN SCHWARTZ PT, DPT, NCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2016
Last Update Date: 01/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 MYRTLE ST
SCRANTON PA
18510-1051
US

IV. Provider business mailing address

823 MYRTLE ST
SCRANTON PA
18510-1051
US

V. Phone/Fax

Practice location:
  • Phone: 484-363-3380
  • Fax: 570-941-7940
Mailing address:
  • Phone: 484-363-3380
  • Fax: 570-941-7940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT018223
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: