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General NPI Number Information
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NPI Number | 1295775963
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Entity Type | Individual
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Provider Name | JEFFREY J. MARON DO
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 144 SNYDER AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19148-2641
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Country | US
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Telephone | 215-336-5566
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Fax | 215-336-5568
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Provider Business Mailing Address
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Address Line | 2 DUNDEE MEWS
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City | MEDIA
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State | PA
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Zip | 19063-1167
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Country | US
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Telephone | 610-325-5701
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Fax | 610-325-9197
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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 | OS003134L
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License Number State | PA
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