Provider Demographics
NPI:1780869347
Name:MURAWSKI, JENNIFER DIANE (PT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:DIANE
Last Name:MURAWSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201B NORTH CHURCH STREET
Mailing Address - Street 2:SUITE 307
Mailing Address - City:HAZLE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18202-1453
Mailing Address - Country:US
Mailing Address - Phone:570-455-7108
Mailing Address - Fax:570-455-8835
Practice Address - Street 1:1201B NORTH CHURCH STREET
Practice Address - Street 2:SUITE 307
Practice Address - City:HAZLE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18202-1453
Practice Address - Country:US
Practice Address - Phone:570-455-7108
Practice Address - Fax:570-455-8835
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011005L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist