Individual
JENNIFER TANZOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4150 REDBUD DR W, WHITEHALL, PA 18052-1952
(610) 502-1090
Mailing address
7450 SCENIC VIEW DR, MACUNGIE, PA 18062-2149
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
OC006476L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019249000003
13 DIGIT PROMISE PROVIDER
PA
Enumeration date
04/09/2007
Last updated
07/08/2007
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