MEDICARE: MISS JENNIFER M PINTO PA-C

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	363AM0700X	Medical Physician Assistant	25MP00164600	NJ

General Provider Information

NPI Number	:	1356422182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JENNIFER M PINTO PA-C

Provider Business Mailing Address
First Line	:	2325 MARYLAND RD
Second Line	:
City	:	WILLOW GROVE
State	:	PA
Zip	:	19090-1749
Country	:	US
Telephone Number	:	215-657-9393
Fax Number	:	215-657-9398

Provider Business Practice Location Address
First Line	:	2325 MARYLAND RD
Second Line	:
City	:	WILLOW GROVE
State	:	PA
Zip	:	19090-1749
Country	:	US
Telephone Number	:	215-657-9393
Fax Number	:	215-657-9398

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	10/24/2019

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