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NPI 1104753151

NPI 1104753151 : BENJAMIN JUDAH JOFFE MD : PHILADELPHIA, PA

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General NPI Number Information
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    NPI Number           |    1104753151
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    Entity Type          |    Individual 
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    Provider Name        |    BENJAMIN JUDAH JOFFE MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/05/2026
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    Last Update Date     |    05/05/2026
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Provider Practice Location Address
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    Address Line         |    3509 N BROAD ST 
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19140-4105
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    Country              |    US
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    Telephone            |    180-083-6753
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1363 INDIAN CREEK DR 
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    City                 |    WYNNEWOOD
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    State                |    PA
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    Zip                  |    19096-3321
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    Country              |    US
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    Telephone            |    610-955-5121
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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        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    MT236489
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    License Number State |    PA
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