| Jefferson University Physicians | |
|
33 S. 9th Street Suite 630 Philadelphia PA 19107 | |
| (215) 955-0800 | |
| Not Available |
| Full Name | Jefferson University Physicians |
|---|---|
| Speciality | Dermatology |
| Location | 33 S. 9th Street, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Colleen Fusetti (ASSOC. VP, HEALTH PLAN SERVICES) |
| Authorized Official Contact | 2159559298 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson University Physicians Po Box 828937 Philadelphia PA 19182-8937 Ph: (215) 503-1240 | Jefferson University Physicians 33 S. 9th Street Suite 630 Philadelphia PA 19107 Ph: (215) 955-0800 |
| NPI Number | 1295011419 |
|---|---|
| Provider Enumeration Date | 11/02/2011 |
| Last Update Date | 06/16/2023 |
| Medicare PECOS PAC ID | 7911819180 |
|---|---|
| Medicare Enrollment ID | O20111212000077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295011419 | NPI | - | NPPES |
| Provider Name | Jonathan Mark Fenkel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1811031222 PECOS PAC ID: 9436204229 Enrollment ID: I20120924000562 |
| Provider Name | Jason B Lee |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1457372963 PECOS PAC ID: 7416914189 Enrollment ID: I20130418000330 |
| Provider Name | Jesse Michael Civan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316000805 PECOS PAC ID: 1456591221 Enrollment ID: I20140807002127 |
| Provider Name | Dina Louise Halegoua De Marzio |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1235347105 PECOS PAC ID: 0941426522 Enrollment ID: I20141016001005 |
| Provider Name | Matthew S Keller |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1194931907 PECOS PAC ID: 7810049004 Enrollment ID: I20141121000465 |
| Provider Name | Kehua Li |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1164488417 PECOS PAC ID: 7416993605 Enrollment ID: I20150303000931 |
| Provider Name | Jamie L Goldberg |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1265725352 PECOS PAC ID: 4880906544 Enrollment ID: I20150709000160 |
| Provider Name | Joshua W Trufant |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1255655205 PECOS PAC ID: 4284860750 Enrollment ID: I20150728003498 |
| Provider Name | Sherry Yang |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1295024057 PECOS PAC ID: 2769607043 Enrollment ID: I20150917001828 |
| Provider Name | Elizabeth Kaberle Jones |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1851736631 PECOS PAC ID: 6204053077 Enrollment ID: I20171010002279 |
| Provider Name | Danielle Marie Tholey |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508156217 PECOS PAC ID: 0941429633 Enrollment ID: I20190507001101 |
| Provider Name | Stephanie R Jackson Cullison |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1457705956 PECOS PAC ID: 3971890708 Enrollment ID: I20210930002002 |
| Provider Name | Ahilan Sivaganesan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1811332174 PECOS PAC ID: 0749582450 Enrollment ID: I20230829002823 |
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