Basic Information
| Provider Information | |||||||||
| NPI: | 1235272899 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEBER | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | EILEEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 409 S 2ND ST STE 2F | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171041612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172318508 | ||||||||
| FaxNumber: | 7172318535 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 MOUNT ALLEN DR | ||||||||
| Address2: | |||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170556171 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177908232 | ||||||||
| FaxNumber: | 7177968147 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 12/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QA0401X | OS006445E | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | Addiction Medicine | 207QG0300X | OS006445E | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine | 207Q00000X | OS006445E | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.