Provider Demographics
NPI:1558318444
Name:PERRONE, JEANMARIE (MD)
Entity Type:Individual
Prefix:
First Name:JEANMARIE
Middle Name:
Last Name:PERRONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 SPRUCE ST.
Mailing Address - Street 2:GROUND SILVERSTEIN BUILDING
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4206
Mailing Address - Country:US
Mailing Address - Phone:215-662-7248
Mailing Address - Fax:215-662-3953
Practice Address - Street 1:3400 SPRUCE ST.
Practice Address - Street 2:GROUND SILVERSTEIN BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4206
Practice Address - Country:US
Practice Address - Phone:215-662-7248
Practice Address - Fax:215-662-3953
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD056362L207PT0002X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015403760002Medicaid
PA0015403760002Medicaid
PA150830Medicare PIN