JEREMY D WITCOSKI (NPI# 1407845845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407845845 |
| Entity Type | Individual |
| Full Name | JEREMY D WITCOSKI |
| Credential | PA |
| Practice Address |
250 Cetronia Rd Allentown PA 18104-9147 |
| Mailing Address |
250 Cetronia Rd Suite 303 Allentown PA 18104-9147 |
| Practice Telephone | 6109736200 |
| Practice Fax Number | 8666440894 |
| Mailing Telephone | 6109736200 |
| Mailing Fax Number | 8666440894 |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2014-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA9103071 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
MA056681 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
250 CETRONIA RD |
| City | ALLENTOWN |
| State | PA |
| Zip Code | 18104-9147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669476081 | Amir H Fayyazi | Orthopaedic Surgery | 250 Cetronia Rd, Allentown, PA 18104-9147 | 2005-06-13 |
| 1043741812 | Amy Devenuto | Physical Therapist | 250 Cetronia Rd, Suite 210, Allentown, PA 18104-9147 | 2017-03-23 |
| 1245788280 | Betsy Green | Occupational Therapist | 250 Cetronia Rd, Suite 220, Allentown, PA 18104-9147 | 2016-09-20 |
| 1154879468 | Lauren Cook | Occupational Therapist | 250 Cetronia Rd, Suite 220, Allentown, PA 18104-9147 | 2016-09-15 |
| 1578922803 | Michael Sidari | Physician Assistant | 250 Cetronia Rd, Allentown, PA 18104 | 2016-02-15 |
| 1184026874 | Steven J Rogalski | Physician Assistant | 250 Cetronia Rd, Allentown, PA 18104-9147 | 2014-09-24 |
| 1568863116 | Maryjane Spotts Cerrone | Clinical Nurse Specialist | 250 Cetronia Rd, Allentown, PA 18104-9147 | 2014-09-12 |
| 1184025447 | Christine Marie Ciaverelli | Physician Assistant | 250 Cetronia Rd, Allentown, PA 18104-9147 | 2014-09-05 |
| 1376942003 | Jonna P Trexler | Physician Assistant | 250 Cetronia Rd, Allentown, PA 18104-9147 | 2014-08-19 |
| 1740606359 | Onyedikachukwu K Momah | Physician Assistant | 250 Cetronia Rd, Allentown, PA 18104-9147 | 2014-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174134191 | The Calm Space LLC | Social Worker | 2047 Pa-309, Allentown, PA 18104 | 2020-08-13 |
| 1790333458 | Loanna T Nguyen | Nurse Practitioner | 2895 Halmilton Blvd, Suite 202, Allentown, PA 18104 | 2019-08-27 |
| 1093360513 | Meghan Paul | Pharmacist | 1727 W Liberty Street, Unit 2, Allentown, PA 18104 | 2019-08-02 |
| 1750948154 | Patricia Terreros | Counselor | 3057 College Heights Blvd Suite Ll, Allentown, PA 18104 | 2019-05-22 |
| 1023593084 | Hearvana | Clinic/Center | 2200 Wets Hamilton Street Suite 311, Allentown, PA 18104 | 2018-09-26 |
| 1700397098 | Amanda L Sellers | Psychologist | 121 N Cedar Crest Blvd Ste A, Allentown, PA 18104 | 2017-10-13 |
| 1689104457 | Craig Ryan Miller | Physical Therapist | 1651 N Cedar Crest Blvd Ste 100, Allentown, PA 18104 | 2017-06-14 |
| 1780128207 | Brandi Nicole Burns | Pediatrics | 1517 Pond Road, Allentown, PA 18104 | 2016-12-19 |
| 1750824264 | William Edward Thawley | Pharmacist | 322 N 7th St., Allentown, PA 18104 | 2016-12-01 |
| 1609222371 | Extremity Mri Inc | Radiologic Technologist | 3131 College Heights Blvd Ste 400, Allentown, PA 18104 | 2016-05-11 |
| Find all providers in zip 18104 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447628169 | Jordan Salibi | Physician Assistant | 1117 Sherman St, Allentown, PA 18109-1716 | 2015-09-11 |
| 1598899809 | Cynthia S. Mang | Physician Assistant | Dept of General Surgery, 1240 S. Cedar Crest Blvd, Allentown, PA 18103 | 2007-03-16 |
| 1558817130 | Christina Marie Strauss | Physician Assistant | 1250 S Cedar Crest Blvd, 215, Allentown, PA 18103-6224 | 2016-09-01 |
| 1225412034 | Ashley Krzemien | Physician Assistant | 1243 S Cedar Crest Blvd Ste 301, Lvpg Plastic and Reconstructive Surgery, Allentown, PA 18103-6268 | 2015-07-13 |
| 1184026874 | Steven J Rogalski | Physician Assistant | 250 Cetronia Rd, Allentown, PA 18104-9147 | 2014-09-24 |
| 1184025447 | Christine Marie Ciaverelli | Physician Assistant | 250 Cetronia Rd, Allentown, PA 18104-9147 | 2014-09-05 |
| 1376942003 | Jonna P Trexler | Physician Assistant | 250 Cetronia Rd, Allentown, PA 18104-9147 | 2014-08-19 |
| 1801203252 | Lauren Christoff | Physician Assistant | 2100 Mack Blvd, Allentown, PA 18103-5622 | 2014-07-17 |
| 1740606359 | Onyedikachukwu K Momah | Physician Assistant | 250 Cetronia Rd, Allentown, PA 18104-9147 | 2014-03-07 |
| 1881016384 | Sarah Clark | Physician Assistant | 250 Cetronia Rd, Allentown, PA 18104-9147 | 2014-01-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.