Provider Demographics
NPI:1043527047
Name:JATTO INTERNAL MEDICINE AND WELLNESS P.C.
Entity Type:Organization
Organization Name:JATTO INTERNAL MEDICINE AND WELLNESS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDETTE
Authorized Official - Middle Name:N
Authorized Official - Last Name:GBEMUDU-JATTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-327-4448
Mailing Address - Street 1:2205 FOREST HILLS DR
Mailing Address - Street 2:SUITE12
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1001
Mailing Address - Country:US
Mailing Address - Phone:717-327-4448
Mailing Address - Fax:717-327-4449
Practice Address - Street 1:2205 FOREST HILLS DR
Practice Address - Street 2:SUITE12
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1001
Practice Address - Country:US
Practice Address - Phone:717-327-4448
Practice Address - Fax:717-327-4449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-12
Last Update Date:2010-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-071505-L261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care