Individual
DR. JEFFREY DONALDSON HENDERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, 6TH FLOOR, PARKINSON PAVILION, PHILADELPHIA, PA 19140-5103
(215) 707-3185
(215) 707-1684
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3185
(215) 707-1684
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD065345L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017739950005
—
PA
Enumeration date
09/08/2005
Last updated
03/21/2017
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