Provider Demographics
NPI:1356003511
Name:JERIN, MINU S
Entity Type:Individual
Prefix:
First Name:MINU
Middle Name:S
Last Name:JERIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 PHILMONT AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-5368
Mailing Address - Country:US
Mailing Address - Phone:215-947-4100
Mailing Address - Fax:
Practice Address - Street 1:52 FERN RD
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3023
Practice Address - Country:US
Practice Address - Phone:267-241-9632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor