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Individual

ALLEN JAY SCHWALB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
520 S 19TH ST, STE 1B, PHILADELPHIA, PA 19146-1449
(215) 545-4173
(215) 545-1543
Mailing address
520 S 19TH ST, STE 1B, PHILADELPHIA, PA 19146-1449
(215) 545-4173
(215) 545-1543

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD018098E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0006293890004
PA
05
0667501
NJ
01
SC104085
PA BLUE SHIELD
PA
Enumeration date
06/30/2005
Last updated
07/10/2012
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