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General NPI Number Information
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NPI Number | 1023104544
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Entity Type | Individual
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Provider Name | JOEL B JURNOVOY MD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2010 WEST CHESTER PIKE SUITE 350
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City | HAVERTOWN
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State | PA
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Zip | 19083-2738
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Country | US
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Telephone | 610-924-0135
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Fax | 610-924-0620
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Provider Business Mailing Address
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Address Line | 3656 WAYNESFIELD DRIVE
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073
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Country | US
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Telephone | 610-353-6463
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD010163E
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License Number State | PA
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