Provider Demographics
NPI:1154030575
Name:SCHIAVO, JAIME (PT)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:
Last Name:SCHIAVO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 MACOBY ST
Mailing Address - Street 2:
Mailing Address - City:PENNSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18073-1112
Mailing Address - Country:US
Mailing Address - Phone:215-679-8076
Mailing Address - Fax:
Practice Address - Street 1:530 MACOBY ST
Practice Address - Street 2:
Practice Address - City:PENNSBURG
Practice Address - State:PA
Practice Address - Zip Code:18073-1112
Practice Address - Country:US
Practice Address - Phone:215-679-8076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
PAPT030906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty