Individual
DR. JASON THOMAS ACKRIVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4230
(215) 614-0871
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4230
(215) 614-0871
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD458117
PA
Other
Enumeration date
03/25/2011
Last updated
11/05/2018
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