Provider Demographics
NPI:1396856969
Name:SCHUBERT, JENNIFER A (PT, CHT)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:A
Last Name:SCHUBERT
Suffix:
Gender:F
Credentials:PT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 US ROUTE 1
Mailing Address - Street 2:SUITE E-1
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7649
Mailing Address - Country:US
Mailing Address - Phone:207-303-3030
Mailing Address - Fax:207-303-3033
Practice Address - Street 1:308 US ROUTE 1
Practice Address - Street 2:SUITE E-1
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7649
Practice Address - Country:US
Practice Address - Phone:207-303-3030
Practice Address - Fax:207-303-3033
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT5272251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM2744Medicare ID - Type Unspecified