Individual
LORI JARDINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5501 OLD YORK RD, GROUND FLOOR, PHILADELPHIA, PA 19141-3018
(215) 254-2730
(215) 254-2735
Mailing address
PO BOX 8500-8735, PHILADELPHIA, PA 19178-8735
(215) 456-7000
(215) 254-2599
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD044651E
PA
2086S0102X
Surgical Critical Care Physician
MD044651E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01240880
—
PA
Enumeration date
08/31/2006
Last updated
09/25/2012
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