MEDICARE: JFK MEDICAL ASSOCIATES PA

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	174400000X	Specialist

General Provider Information

NPI Number	:	1285078592
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JFK MEDICAL ASSOCIATES PA

Provider Business Mailing Address
First Line	:	PO BOX 95000-7710
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19195-0001
Country	:	US
Telephone Number	:	888-571-5280
Fax Number	:	732-922-0914

Provider Business Practice Location Address
First Line	:	3600 ROUTE 66 FL 3
Second Line	:
City	:	NEPTUNE
State	:	NJ
Zip	:	07753-2645
Country	:	US
Telephone Number	:	888-571-5280
Fax Number	:	732-922-0914

Authorized Official
Title or Position	:	CFO
Name	:	MR. RICHARD C SMITH
Credential	:
Telephone Number	:	732-321-7747

Provider Enumeration Date	:	04/18/2013
Last Update Date	:	03/31/2021

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