Provider Demographics
NPI:1023137072
Name:CONNOR, JANET (PT)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:CONNOR
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 1:105 MACINTOSH CT
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-1985
Mailing Address - Country:US
Mailing Address - Phone:215-806-8748
Mailing Address - Fax:
Practice Address - Street 1:146 EDGE HILL RD
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-3004
Practice Address - Country:US
Practice Address - Phone:215-886-1043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007872-L111N00000X
PAPT017845225100000X
NCP6988225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA050852P2HMedicare ID - Type Unspecified