Organization
JANE M HEANEY DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE M HEANEY D.O. (PRESIDENT OWNER)
(215) 483-7200
Entity
Organization
Contact information
Practice address
110 LEVERING ST, PHILADELPHIA, PA 19127-1404
(215) 483-7200
(215) 483-2122
Mailing address
4000 GYPSY LN UNIT 405, PHILADELPHIA, PA 19129-5426
(215) 848-4062
(215) 848-4552
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS 005958-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118925-0002
—
PA
01
—
2258275001
KEYSTONE
PA
01
—
4547198
AETNA
PA
Enumeration date
06/28/2007
Last updated
08/22/2020
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