Healthcare Provider Details

I. General information

NPI: 1235176397
Provider Name (Legal Business Name): TRI-COUNTY PEDIATRICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1939 W CHELTENHAM AVE
ELKINS PARK PA
19027-1046
US

IV. Provider business mailing address

1939 W CHELTENHAM AVE
ELKINS PARK PA
19027-1046
US

V. Phone/Fax

Practice location:
  • Phone: 215-884-5715
  • Fax: 215-884-1442
Mailing address:
  • Phone: 215-884-5715
  • Fax: 215-884-1442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LEE JAFFEE
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 215-884-5715