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1619039260

NPI Code Detail

MEDICARE: DR. JENIA JENAB-WOLCOTT M.D.

MEDICARE: DR. JENIA JENAB-WOLCOTT M.D.

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	207RH0003X	Hematology & Oncology Physician	D76252	MD
2	207RX0202X	Medical Oncology Physician	MD436012	PA
3	207RH0003X	Hematology & Oncology Physician	MD436012	PA
4	207R00000X	Internal Medicine Physician	436012	PA
5	207RH0003X	Hematology & Oncology Physician	C10010448	DE
6	207RH0003X	Hematology & Oncology Physician	25MA09275100	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C10010448	OTHER	DE	MEDICAL LICENSE
2	436012	OTHER	PA	MEDICAL LICENSE
3	D76252	OTHER	MD	MEDICAL LICENSE

General Provider Information

NPI Number	:	1619039260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENIA JENAB-WOLCOTT M.D.

Provider Business Mailing Address
First Line	:	1 FEDERAL ST # 200
Second Line	:
City	:	CAMDEN
State	:	NJ
Zip	:	08103-1088
Country	:	US
Telephone Number	:	856-356-4924
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 COOPER PLZ
Second Line	:
City	:	CAMDEN
State	:	NJ
Zip	:	08103-1461
Country	:	US
Telephone Number	:	855-632-2667
Fax Number	:

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	01/22/2026

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Directions to “ DR. JENIA JENAB-WOLCOTT M.D.” Practice Location

Language	Start Address	Practice Location

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