Janine Diane Wiciak

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TE005319L Issued in PA

Practice address

111 Elwyn Rd
Kivitz BLDG - Phys Rehab
Elwyn, PA 19063-4622

Phone

(610) 891-2214

Fax

(610) 891-2280

NPI assigned

Apr 21, 2009

Last updated

Apr 21, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1477797405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ELWYN ROAD",
            "address_2": "KIVITZ BLDG - PHYS REHAB",
            "city": "ELWYN",
            "state": "PA",
            "postal_code": "190634622",
            "telephone_number": "610-891-2214",
            "fax_number": "610-891-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ELWYN RD",
            "address_2": "KIVITZ BLDG - PHYS REHAB",
            "city": "ELWYN",
            "state": "PA",
            "postal_code": "190634622",
            "telephone_number": "610-891-2214",
            "fax_number": "610-891-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICIAK",
        "first_name": "JANINE",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE005319L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosanna Patricia Suppa, MA CCCLA
• Edlira Tegu, PMHNP
• Jennifer Lynn Torrey, LPC
• Margaret Twigg, OTRL
• Francine Vasquez
• Alexis Nicole Woodward, BS ED

• Physical Therapy Assistant in Elwyn, PA
• Providers in Elwyn, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.