Individual
MS. JILL SHERRARD REA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00933900
NJ
225100000X
Physical Therapist
PT013946L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001423766
HIGHMARK BLUE SHIELD
PA
05
—
1011231150001
—
PA
01
—
2109683000
IBC
PA
Enumeration date
03/03/2006
Last updated
03/16/2009
Update your record
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