Provider Demographics
NPI:1568622298
Name:JAN, ARIF M (MD)
Entity Type:Individual
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First Name:ARIF
Middle Name:M
Last Name:JAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1601 CHERRY ST
Mailing Address - Street 2:SUITE 11511
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1321
Mailing Address - Country:US
Mailing Address - Phone:215-255-7822
Mailing Address - Fax:215-255-7825
Practice Address - Street 1:1427 VINE ST
Practice Address - Street 2:6TH FL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1031
Practice Address - Country:US
Practice Address - Phone:215-762-6565
Practice Address - Fax:215-762-6997
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2015-11-06
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Provider Licenses
StateLicense IDTaxonomies
PAMD440331207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102506390Medicaid
PA189259Medicare PIN