Provider Demographics
NPI:1437706926
Name:RATH, JEAN ELIZABETH (PHDHP)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:ELIZABETH
Last Name:RATH
Suffix:
Gender:F
Credentials:PHDHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4439 TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-1629
Mailing Address - Country:US
Mailing Address - Phone:856-317-6020
Mailing Address - Fax:
Practice Address - Street 1:160 E ERIE AVE # N1-08
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-1011
Practice Address - Country:US
Practice Address - Phone:215-427-4383
Practice Address - Fax:215-291-7091
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPHDH000445124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist