Provider Demographics
NPI:1134671522
Name:JASLOW, LEE
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:
Last Name:JASLOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 QUEENS DR
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-4625
Mailing Address - Country:US
Mailing Address - Phone:215-378-0052
Mailing Address - Fax:
Practice Address - Street 1:1592 ROUTE 739
Practice Address - Street 2:2
Practice Address - City:DINGMANS FERRY
Practice Address - State:PA
Practice Address - Zip Code:18328-3513
Practice Address - Country:US
Practice Address - Phone:570-828-7494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP029755L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP029755LOtherBOARD OF PHARMACY