MEDICARE: DR. JONATHAN ANTHONY VU

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	207L00000X	Anesthesiology Physician	OS021500	PA

General Provider Information

NPI Number	:	1518348721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN ANTHONY VU

Provider Business Mailing Address
First Line	:	3803 W CHESTER PIKE STE 160
Second Line	:
City	:	NEWTOWN SQUARE
State	:	PA
Zip	:	19073-2336
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 E LANCASTER AVE
Second Line	:	SUITE 53 MOB EAST
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-3415
Country	:	US
Telephone Number	:	610-658-1928
Fax Number	:

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

Provider Enumeration Date	:	06/12/2015
Last Update Date	:	10/15/2024

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