MEDICARE: JEFFREY SYEN RPH

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	183500000X	Pharmacist	RP029183L	PA

General Provider Information

NPI Number	:	1902124985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY SYEN RPH

Provider Business Mailing Address
First Line	:	2542 FAUNCE ST
Second Line	:	APT. A
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-4122
Country	:	US
Telephone Number	:	215-331-2069
Fax Number	:

Provider Business Practice Location Address
First Line	:	4530 N 5TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-1423
Country	:	US
Telephone Number	:	215-455-7330
Fax Number	:

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

Provider Enumeration Date	:	05/14/2010
Last Update Date	:	05/14/2010

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Directions to “ JEFFREY SYEN RPH” Practice Location

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