Provider Demographics
NPI:1447415484
Name:COMIA, JENNIELYN B (MD)
Entity Type:Individual
Prefix:
First Name:JENNIELYN
Middle Name:B
Last Name:COMIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIELYN
Other - Middle Name:P
Other - Last Name:BUMANLAG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8835 GERMANTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-2718
Mailing Address - Country:US
Mailing Address - Phone:215-248-8200
Mailing Address - Fax:
Practice Address - Street 1:8835 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-2718
Practice Address - Country:US
Practice Address - Phone:215-248-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD443140208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist