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General NPI Number Information
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NPI Number | 1023789666
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Entity Type | Individual
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Provider Name | JUSTIN GREG JOFFE PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/23/2021
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 3400 SPRUCE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4238
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Country | US
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Telephone | 215-316-5151
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Fax |
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Provider Business Mailing Address
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Address Line | 305 KENT RD
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City | BALA CYNWYD
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State | PA
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Zip | 19004-2823
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Country | US
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Telephone | 215-500-3423
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA063046
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License Number State | PA
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