Provider Demographics
NPI:1750617437
Name:PODLINSKI, JENYNE MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:JENYNE
Middle Name:MARIE
Last Name:PODLINSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JENYNE
Other - Middle Name:MARIE
Other - Last Name:SCARPATI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 1754
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-1754
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 E BROAD ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-6835
Practice Address - Country:US
Practice Address - Phone:570-501-4193
Practice Address - Fax:570-501-4109
Is Sole Proprietor?:No
Enumeration Date:2009-10-30
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054152363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant