Provider Demographics
NPI:1205291358
Name:ZEFF, JESSICA ELLEN (OT)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ELLEN
Last Name:ZEFF
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:ELLEN
Other - Last Name:HAACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:2400 WILDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-6404
Mailing Address - Country:US
Mailing Address - Phone:412-487-7771
Mailing Address - Fax:412-487-7772
Practice Address - Street 1:2400 WILDWOOD RD
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-6404
Practice Address - Country:US
Practice Address - Phone:412-487-7771
Practice Address - Fax:412-487-7772
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X, 225XP0200X
PAOC014032225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103116989-0001Medicaid