MEDICARE: JANA M BARMASSE PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	40QA01495600	NJ

General Provider Information

NPI Number	:	1104263219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANA M BARMASSE PT

Provider Business Mailing Address
First Line	:	740 MARNE HWY
Second Line	:	SUITE 203
City	:	MOORESTOWN
State	:	NJ
Zip	:	08057-3126
Country	:	US
Telephone Number	:	856-914-1400
Fax Number	:	856-914-1444

Provider Business Practice Location Address
First Line	:	740 MARNE HWY
Second Line	:	SUITE 203
City	:	MOORESTOWN
State	:	NJ
Zip	:	08057-3126
Country	:	US
Telephone Number	:	856-914-1400
Fax Number	:	856-914-1444

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2013
Last Update Date	:	05/30/2013

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