Jennifer Maryniak, ATC, MED., CSCS

Individual provider Active NPI Athletic Trainer · Laureldale, PA

NPI 1770632242 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1770632242
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
RT001529A (PA)
Practice address
Sharp & Francis Streets
Laureldale, PA 19605
Phone
(610) 921-8078
Fax
(610) 921-7922
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
RT001529APAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT001529A PA Yes

Addresses

Primary practice location

Sharp & Francis Streets
Laureldale, PA 19605

Mailing address

2 Musket LN
Shillington, PA 19607-9541
Phone (610) 921-8078

Other providers in Laureldale, PA

All providers in Laureldale, PA · Athletic Trainer in Pennsylvania

Sources for this page

Verify at the official NPI Registry.