Provider Demographics
NPI:1619499688
Name:NAUERTH, JENNA MARIE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:MARIE
Last Name:NAUERTH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:MARIE
Other - Last Name:MARTENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:99 LANARK CRES
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-7863
Mailing Address - Country:US
Mailing Address - Phone:315-289-7721
Mailing Address - Fax:
Practice Address - Street 1:150 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3024
Practice Address - Country:US
Practice Address - Phone:585-760-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036725-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist