Provider Demographics
NPI:1770819179
Name:FILIP, JENNIFER (PA-C, MS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:FILIP
Suffix:
Gender:F
Credentials:PA-C, MS
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 E ALLEGHENY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-4401
Mailing Address - Country:US
Mailing Address - Phone:215-427-1111
Mailing Address - Fax:215-427-7799
Practice Address - Street 1:2310 E ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-4401
Practice Address - Country:US
Practice Address - Phone:215-427-1111
Practice Address - Fax:215-427-7799
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054102363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant