MEDICARE: JENNIFER G PATTERSON D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS019702	PA

General Provider Information

NPI Number	:	1194108779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER G PATTERSON D.O.

Provider Business Mailing Address
First Line	:	175 STRAFFORD AVE STE 222
Second Line	:
City	:	WAYNE
State	:	PA
Zip	:	19087-3317
Country	:	US
Telephone Number	:	888-702-7974
Fax Number	:

Provider Business Practice Location Address
First Line	:	175 STRAFFORD AVE STE 222
Second Line	:
City	:	WAYNE
State	:	PA
Zip	:	19087-3317
Country	:	US
Telephone Number	:	888-702-7974
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2015
Last Update Date	:	02/27/2025

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