Healthcare Provider Details

I. General information

NPI: 1205816881
Provider Name (Legal Business Name): JOSEPH J PRICE JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 LANSDOWNE AVE STE 201
DARBY PA
19023-1333
US

IV. Provider business mailing address

1501 LANSDOWNE AVE STE 201
DARBY PA
19023-1333
US

V. Phone/Fax

Practice location:
  • Phone: 610-534-6230
  • Fax: 610-534-6166
Mailing address:
  • Phone: 610-534-6230
  • Fax: 610-534-6166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD043660E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD043660E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: