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NPI Code Detail

MEDICARE: IRA JAY BLEIWEISS MD

MEDICARE: IRA JAY BLEIWEISS MD
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
1207ZP0105XClinical Pathology/Laboratory Medicine PhysicianMD034904EPA
2207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianMD034904EPA

General Provider Information

NPI Number : 1851399869
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRA JAY BLEIWEISS MD
Provider Business Mailing Address
First Line : 800 SPRUCE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19107-6130
Country : US
Telephone Number : 215-829-3000
Fax Number : 215-829-7564
Provider Business Practice Location Address
First Line : 800 SPRUCE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19107-6130
Country : US
Telephone Number : 215-829-3000
Fax Number : 215-829-7564
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 10/24/2019

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