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NPI Code Detail

MEDICARE: JENNIFER MARIE CORBETT OTR/L

MEDICARE: JENNIFER MARIE CORBETT OTR/L
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
1225X00000XOccupational Therapist014217NY

General Provider Information

NPI Number : 1578752689
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MARIE CORBETT OTR/L
Provider Business Mailing Address
First Line : 710 WOLCOTT DR APT C
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19118-4324
Country : US
Telephone Number : 631-872-3032
Fax Number :
Provider Business Practice Location Address
First Line : 600 W CHELTENHAM AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19126-3045
Country : US
Telephone Number : 631-872-3032
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2007
Last Update Date : 09/24/2016

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