Provider Demographics
NPI:1801202924
Name:KUSHNER, JEFFREY ALBERT (DO)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ALBERT
Last Name:KUSHNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 BITTERSWEET DR
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2770
Mailing Address - Country:US
Mailing Address - Phone:484-919-7367
Mailing Address - Fax:
Practice Address - Street 1:2003 LOWER STATE RD BLDG 200
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2622
Practice Address - Country:US
Practice Address - Phone:215-345-6647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-09
Last Update Date:2020-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS019191207N00000X
MIUO4054207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology