Provider Demographics
NPI:1871749267
Name:CARAPETYAN, JENNIFER INJAIAN (PT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:INJAIAN
Last Name:CARAPETYAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:INJAIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:542 BERLIN CROSS KEYS RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-4367
Mailing Address - Country:US
Mailing Address - Phone:856-740-0009
Mailing Address - Fax:856-262-0469
Practice Address - Street 1:542 BERLIN CROSS KEYS RD
Practice Address - Street 2:SUITE 1
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-4367
Practice Address - Country:US
Practice Address - Phone:856-740-0009
Practice Address - Fax:856-262-0469
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ10002391225100000X
NJ40QA01368000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
3686777000OtherIBC AMERIHEALTH
DE1871749267Medicaid
DE139131Y0XMedicare PIN