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General NPI Number Information
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NPI Number | 1902918386
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Entity Type | Individual
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Provider Name | JANINE ELVIRA PAYSON PA
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 266 LANCASTER AVE STE 200
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City | MALVERN
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State | PA
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Zip | 19355-3256
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Country | US
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Telephone | 610-644-6900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 34990
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City | BELFAST
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State | ME
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Zip | 04915-0627
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Country | US
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Telephone |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA064320
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License Number State | PA
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