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General NPI Number Information
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NPI Number | 1548229826
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Entity Type | Individual
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Provider Name | JENNIFER SUE BIRNSTEIN PA-C, ATC, MSED.
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Gender | Female
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 02/12/2021
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Provider Practice Location Address
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Address Line | 501 DISCOVERY DR
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City | CHESAPEAKE
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State | VA
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Zip | 23320-3843
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Country | US
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Telephone | 757-547-5145
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Fax |
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Provider Business Mailing Address
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Address Line | 501 DISCOVERY DR
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City | CHESAPEAKE
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State | VA
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Zip | 23320-3843
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Country | US
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Telephone | 757-547-5145
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 0110840814
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License Number State | VA
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