Provider Demographics
NPI:1669473641
Name:JEHA, ZEINA (MD)
Entity Type:Individual
Prefix:
First Name:ZEINA
Middle Name:
Last Name:JEHA
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:PO BOX 323
Mailing Address - Street 2:
Mailing Address - City:NASSAU
Mailing Address - State:DE
Mailing Address - Zip Code:19969-0323
Mailing Address - Country:US
Mailing Address - Phone:302-644-0999
Mailing Address - Fax:302-644-3099
Practice Address - Street 1:16295 WILLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-3614
Practice Address - Country:US
Practice Address - Phone:302-644-0999
Practice Address - Fax:302-644-3099
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10005201207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G65050Medicare UPIN
G00854Medicare ID - Type Unspecified