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General NPI Number Information
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NPI Number | 1790135358
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Entity Type | Individual
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Provider Name | JEFFREY ANTHONY GAZZARA JR. DO
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Gender | Male
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Dates
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Enumeration Date | 06/14/2016
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Last Update Date | 04/06/2023
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Provider Practice Location Address
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Address Line | 621, 1515 MARKET STREET SUITE 1200
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1921
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Country | US
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Telephone | 856-236-0155
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Fax |
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Provider Business Mailing Address
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Address Line | 164 KENNEDY BLVD
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City | BELLMAWR
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State | NJ
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Zip | 08031-1121
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Country | US
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Telephone | 856-236-0155
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 302466
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | DR.0063013
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 2020003560
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | SP.243
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 032.0133783
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License Number State | VT
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Taxonomy #6
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | DO2764
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License Number State | ME
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Taxonomy #7
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ITRDO-008
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License Number State | WV
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Taxonomy #8
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 5101022520
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License Number State | MI
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Taxonomy #9
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | OS15642
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License Number State | FL
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Taxonomy #10
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 847321
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License Number State | GA
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Taxonomy #11
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | OS018948
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License Number State | PA
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