Individual
DR. JAY L. FEDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 PRESIDENTIAL BLVD, SUITE 100, BALA CYNWYD, PA 19004-1108
(800) 331-6634
(267) 420-1360
Mailing address
4060 BUTLER PIKE, SUITE 200, PLYMOUTH MEETING, PA 19462-1560
(800) 331-6634
(267) 420-1360
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MA04747900
NJ
207W00000X
Ophthalmology Physician
Primary
MD009276E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000751607-0002
—
PA
05
—
2176602
—
NJ
Enumeration date
02/09/2006
Last updated
12/02/2016
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