Individual
DR. JAY GHADIALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-2454
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-2454
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT210707
PA
207RR0500X
Rheumatology Physician
Primary
MT210707
PA
Other
Enumeration date
06/12/2016
Last updated
02/20/2020
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