Provider Demographics
NPI:1508302456
Name:GODLEWSKI, JESSICA (DPT)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:GODLEWSKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:BARBERIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2000 CLIFFMINE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15275-1008
Mailing Address - Country:US
Mailing Address - Phone:412-494-4550
Mailing Address - Fax:412-494-2551
Practice Address - Street 1:2000 CLIFFMINE RD STE 110
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275-1008
Practice Address - Country:US
Practice Address - Phone:412-494-4550
Practice Address - Fax:412-494-4551
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA012742225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist