1093083198 NPI number — MS. JESSICA PARKES HOFFER M.S., OTR/L

Table of content: MS. JESSICA PARKES HOFFER M.S., OTR/L (NPI 1093083198)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093083198 NPI number — MS. JESSICA PARKES HOFFER M.S., OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOFFER
Provider First Name:
JESSICA
Provider Middle Name:
PARKES
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., OTR/L
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093083198
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11 W CENTER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MYERSTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17067-1506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-751-2391
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1829 NEW HOLLAND RD
Provider Second Line Business Practice Location Address:
SUITE 13
Provider Business Practice Location Address City Name:
READING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19607-2229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-301-3259
Provider Business Practice Location Address Fax Number:
610-621-4539
Provider Enumeration Date:
12/05/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  OC011738 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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