Active NPI
Jenna Syken, LAT, ATC
- Prevention Professional
- Prospect Park, PA
National Provider Identifier
1477093409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- RT006054
- Practice address
- 500 16TH Ave
Prospect Park, PA 19076-1120 - Phone
- (610) 237-6410
- NPI assigned
- Feb 23, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | RT006054 | PA | Primary |
Addresses
Primary practice location
500 16TH Ave
Prospect Park, PA 19076-1120
Mailing address
114 Durfor St
Philadelphia, PA 19148-4008
Phone (302) 377-9239
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT006054 | PA | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487808000000",
"number": "1477093409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 DURFOR ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191484008",
"telephone_number": "302-377-9239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 16TH AVE",
"city": "PROSPECT PARK",
"state": "PA",
"postal_code": "190761120",
"telephone_number": "610-237-6410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYKEN",
"first_name": "JENNA",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-23",
"last_updated": "2017-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "PA",
"license": "RT006054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prospect Park, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.