Provider Demographics
NPI:1114656725
Name:BAKAJ, JOCELYN (PTA)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:BAKAJ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-8252
Mailing Address - Country:US
Mailing Address - Phone:814-574-4298
Mailing Address - Fax:
Practice Address - Street 1:68 SPRING ST
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-1911
Practice Address - Country:US
Practice Address - Phone:800-230-4565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant