Provider Demographics
NPI:1073520276
Name:FISHER, JONATHAN AARON (PT)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:AARON
Last Name:FISHER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7307
Mailing Address - Country:US
Mailing Address - Phone:610-861-8080
Mailing Address - Fax:610-807-0366
Practice Address - Street 1:2775 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7307
Practice Address - Country:US
Practice Address - Phone:610-861-8080
Practice Address - Fax:610-807-0366
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018203225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1881214OtherHIGHMARK BLUE SHIELD
2742573000OtherAMERIHEALTH
47241OtherGEISINGER HEALTH PLAN
50071585OtherKEYSTONE HEALTH PLAN CENTRAL
50071585OtherCAPITAL BLUE CROSS
8191681OtherCIGNA HEALTHCARE
2742573000OtherINDEPENDENCE BLUE CROSS
2742573000OtherKEYSTONE HEALTH PLAN EAST
448842OtherHEALTHAMERICA/HEALTHASSURANCE
820605OtherFIRST PRIORITY HEALTH
1509367OtherAETNA HMO
7295851OtherAETNA PPO
P00403153OtherMEDICARE RAILROAD
1881214OtherHIGHMARK BLUE SHIELD