Individual
VIVEK JAYASCHANDRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141
(215) 456-7890
Mailing address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7890
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301107140
MI
207RP1001X
Pulmonary Disease Physician
Primary
MT214836
PA
Other
Enumeration date
07/15/2015
Last updated
06/20/2018
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