1285863456 NPI number — JESSICA HOLLOCK-SINCLAIR MS, PT

Table of content: JESSICA HOLLOCK-SINCLAIR MS, PT (NPI 1285863456)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285863456 NPI number — JESSICA HOLLOCK-SINCLAIR MS, PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLLOCK-SINCLAIR
Provider First Name:
JESSICA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, PT
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:
1285863456
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
520 PHILADELPHIA STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIANA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-463-7478
Provider Business Mailing Address Fax Number:
724-463-0931

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
311 MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18704-5428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-711-8093
Provider Business Practice Location Address Fax Number:
570-718-0938
Provider Enumeration Date:
07/09/2009

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: 225100000X , with the licence number:  PT019202 , 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)





Copyright © 2007-2025 www.npivalidator.com