Individual
DR. JARED SAMUEL MESHEKOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-7237
(215) 707-9389
Mailing address
3500 N BROAD ST, PHILADELPHIA, PA 19140-4106
(215) 707-3411
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
25MA10105200
NJ
2085R0202X
Diagnostic Radiology Physician
Primary
MD460430
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
293778
NYS LICENSE
NY
01
—
A400195383
MEDICARE
NY
Enumeration date
04/05/2012
Last updated
12/30/2024
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