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General NPI Number Information
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NPI Number | 1629395264
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Entity Type | Individual
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Provider Name | JAY ALBANESE DDS, MD
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Gender | Male
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Dates
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Enumeration Date | 04/21/2010
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Last Update Date | 02/26/2021
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Provider Practice Location Address
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Address Line | 300 OLD FORGE LN STE 301
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-1897
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Country | US
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Telephone | 484-926-6001
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Fax | 484-926-6002
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Provider Business Mailing Address
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Address Line | 300 OLD FORGE LN STE 301
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-1932
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Country | US
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Telephone | 484-926-6001
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Fax | 484-926-6002
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD457711
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS039439
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License Number State | PA
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