Provider Demographics
NPI:1144702861
Name:JAIN, SAURIN (DPT ,PT)
Entity type:Individual
Prefix:
First Name:SAURIN
Middle Name:
Last Name:JAIN
Suffix:
Gender:M
Credentials:DPT ,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 COVENTRY LN
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-9429
Mailing Address - Country:US
Mailing Address - Phone:163-618-4647
Mailing Address - Fax:
Practice Address - Street 1:1048 W BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-6300
Practice Address - Country:US
Practice Address - Phone:610-891-3861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023146208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation