MEDICARE: JAMIE KOSLOP LPN

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1336590538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE KOSLOP LPN

Provider Business Mailing Address
First Line	:	1201B N CHURCH ST
Second Line	:	SUITE 310
City	:	HAZLE TOWNSHIP
State	:	PA
Zip	:	18202-1455
Country	:	US
Telephone Number	:	570-455-6242
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201B N CHURCH ST
Second Line	:	SUITE 310
City	:	HAZLE TOWNSHIP
State	:	PA
Zip	:	18202-1455
Country	:	US
Telephone Number	:	570-455-6242
Fax Number	:

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

Provider Enumeration Date	:	06/29/2016
Last Update Date	:	06/29/2016

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