Provider Demographics
NPI:1386688737
Name:SABOL, JENNIFER (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:SABOL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:SUITE 275 LANKENAU MED SCI BLDG.
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-642-1908
Mailing Address - Fax:610-642-6808
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:SUITE 275 LANKENAU MED SCI BLDG.
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-642-1908
Practice Address - Fax:610-642-6808
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD054460L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG38335Medicare UPIN
PA446145HK1Medicare PIN