Provider Demographics
NPI:1689223299
Name:LITTMAN, EMILY JORDANA (PA-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JORDANA
Last Name:LITTMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1363 N 31ST ST APT 421
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19121-4567
Mailing Address - Country:US
Mailing Address - Phone:845-642-0267
Mailing Address - Fax:
Practice Address - Street 1:834 WALNUT ST STE 650
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5109
Practice Address - Country:US
Practice Address - Phone:215-955-5161
Practice Address - Fax:215-923-6003
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA061191363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant