Healthcare Provider Details

I. General information

NPI: 1366498479
Provider Name (Legal Business Name): THE PHILIP JAISOHN MEMORIAL FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6705 OLD YORK RD
PHILADELPHIA PA
19126-2841
US

IV. Provider business mailing address

6705 OLD YORK RD
PHILADELPHIA PA
19126-2841
US

V. Phone/Fax

Practice location:
  • Phone: 215-224-2000
  • Fax: 215-224-8651
Mailing address:
  • Phone: 215-224-2000
  • Fax: 215-224-8651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. GEORGE JUNG SOO CHOE
Title or Position: CHAIRMAN
Credential: PRESIDENT & CEO
Phone: 215-224-2000