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General NPI Number Information
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NPI Number | 1801069414
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Entity Type | Organization
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Legal Business Name | JEFFREY J MARON DO PC
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Dates
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Enumeration Date | 04/04/2008
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Last Update Date | 04/04/2008
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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 | 215-732-6744
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Fax |
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Provider Business Mailing 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 | 215-732-6744
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | DR. ILENE WARNER-MARON
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Credential |
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Telephone | 610-917-0255
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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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