Provider Demographics
NPI:1760677983
Name:OLARSCH, JENNIFER (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:OLARSCH
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 BOGERTS MILL RD
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07640-1714
Mailing Address - Country:US
Mailing Address - Phone:201-750-2088
Mailing Address - Fax:
Practice Address - Street 1:365 ROUTE 304
Practice Address - Street 2:SUITE102
Practice Address - City:BARDONIA
Practice Address - State:NY
Practice Address - Zip Code:10954-1601
Practice Address - Country:US
Practice Address - Phone:845-624-2182
Practice Address - Fax:201-624-2188
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015133-1225100000X
NJ40QA00811600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist