Individual
JAYA AYSOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3701 MARKET STREET, 6TH FLOOR, SUITE 640, PHILADELPHIA, PA 19104
(215) 662-2250
Mailing address
3701 MARKET STREET, 6TH FLOOR, SUITE 640, PHILADELPHIA, PA 19104
(215) 662-2250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD446797
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457035
—
LA
Enumeration date
12/21/2006
Last updated
09/14/2015
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