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NPI Code Detail

MEDICARE: MRS. JAYNE E BIRD MD

MEDICARE: MRS. JAYNE E BIRD MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMD453889PA

General Provider Information

NPI Number : 1871887620
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JAYNE E BIRD MD
Provider Business Mailing Address
First Line : 1516 LOCUST ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19102-4409
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1516 LOCUST ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19102-4409
Country : US
Telephone Number : 215-545-5458
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2011
Last Update Date : 06/29/2015

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Directions to “ MRS. JAYNE E BIRD MD” Practice Location

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