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Individual

JERRY MILTON TRACHTENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
WORKHEALTH KNIGHTS & RED LION RDS, SUITE 206-MOB, PHILADELPHIA, PA 19114
(215) 612-4836
(215) 612-4904
Mailing address
7044 LYNFORD ST, PHILADELPHIA, PA 19149-1714
(215) 725-6713

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0S005352-L
PA

Other

Enumeration date
08/22/2006
Last updated
07/08/2007
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