Provider Demographics
NPI:1609837533
Name:FAUST, JEFFREY SCOTT (MPT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:FAUST
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:326 ROUTE 61 S
Mailing Address - Street 2:FAUST PHYSICAL THERAPY CENTER
Mailing Address - City:SCHUYLKILL HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17972-9706
Mailing Address - Country:US
Mailing Address - Phone:570-385-5080
Mailing Address - Fax:570-385-5087
Practice Address - Street 1:326 ROUTE 61 S
Practice Address - Street 2:FAUST PHYSICAL THERAPY CENTER
Practice Address - City:SCHUYLKILL HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17972-9706
Practice Address - Country:US
Practice Address - Phone:570-385-5080
Practice Address - Fax:570-385-5087
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT002808E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1878152OtherHIGHMARK BLUE SHIELD
PA485533OtherHIGHMARK BLUE SHIELD
PA439219OtherHEALTHAMERICA ASSURANCE
PA50060598OtherCAPITAL BLUECROSS
PAF146603OtherIHP
PA50060604OtherCAPITAL BLUECROSS
PA5209502OtherAETNA
PA5209502OtherAETNA