Individual
JOSEPHINE LONTOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9501 ROOSEVELT BLVD, SUITE 208, PHILADELPHIA, PA 19114-1025
(215) 464-9634
(215) 969-2327
Mailing address
9501 ROOSEVELT BLVD, SUITE 208, PHILADELPHIA, PA 19114-1025
(215) 464-9634
(215) 969-2327
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT189048
PA
207RI0200X
Infectious Disease Physician
Primary
MD442140
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027311050001
—
PA
Enumeration date
06/17/2008
Last updated
08/13/2014
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