Provider Demographics
NPI:1851374094
Name:SHRAGER, JENNIFER LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:SHRAGER
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:345 SCARLET ROAD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348
Mailing Address - Country:US
Mailing Address - Phone:610-444-1884
Mailing Address - Fax:610-444-1894
Practice Address - Street 1:345 SCARLET ROAD
Practice Address - Street 2:SUITE 12
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348
Practice Address - Country:US
Practice Address - Phone:610-444-1884
Practice Address - Fax:610-444-1894
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2007-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD064643L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016977300005Medicaid