Healthcare Provider Details

I. General information

NPI: 1710029319
Provider Name (Legal Business Name): JEFFREY DEAN ERNST M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 POLLY DRUMMOND HILL RD
NEWARK DE
19711-5703
US

IV. Provider business mailing address

19 LONGVIEW RD
GLEN MILLS PA
19342-8120
US

V. Phone/Fax

Practice location:
  • Phone: 302-738-6859
  • Fax: 302-368-5309
Mailing address:
  • Phone: 610-361-8362
  • Fax: 302-368-5309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: