Provider Demographics
NPI:1629167572
Name:SIPPEL, JANE (PT)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:SIPPEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:BURRILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:296 FLOUR LN
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1527
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 E GLOUCESTER PIKE
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08007-1323
Practice Address - Country:US
Practice Address - Phone:856-547-4422
Practice Address - Fax:856-547-0660
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00924000174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2246946OtherUNITEDHEALTHCARE MPIN
NJ2229157OtherFIRST HEALTH
NJ5234087OtherCIGNA PPO
NJ1301125OtherAMERIHEALTH
NJ1301125OtherAMERIHEALTH