Individual
DR. JORDAN L LASTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 HADDON AVE FL 6, CAMDEN, NJ 08103-3101
(856) 757-3500
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MT222893
PA
Other
Enumeration date
06/24/2021
Last updated
11/22/2024
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