Provider Demographics
NPI:1245204551
Name:JELLINEK, SHARON S (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:S
Last Name:JELLINEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 ROUTE 202
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901
Mailing Address - Country:US
Mailing Address - Phone:215-230-7290
Mailing Address - Fax:215-230-7291
Practice Address - Street 1:3655 ROUTE 202
Practice Address - Street 2:SUITE 100
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901
Practice Address - Country:US
Practice Address - Phone:215-230-7290
Practice Address - Fax:215-230-7291
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA068431L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
E75994Medicare UPIN