Provider Demographics
NPI:1093044091
Name:JONATHAN N SAUNDERS MD PA
Entity Type:Organization
Organization Name:JONATHAN N SAUNDERS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LENNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-368-9611
Mailing Address - Street 1:E62 OMEGA PROFESSIONAL CENTER
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2061
Mailing Address - Country:US
Mailing Address - Phone:302-368-9611
Mailing Address - Fax:302-368-3424
Practice Address - Street 1:E62 OMEGA PROFESSIONAL CENTER
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2061
Practice Address - Country:US
Practice Address - Phone:302-368-9611
Practice Address - Fax:302-368-3424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE000381501Medicaid
E18823Medicare UPIN