Provider Demographics
NPI:1851331052
Name:LIT, JOAN AVA (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:AVA
Last Name:LIT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9501 ROOSEVELT BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1025
Mailing Address - Country:US
Mailing Address - Phone:215-969-9511
Mailing Address - Fax:215-969-9512
Practice Address - Street 1:9501 ROOSEVELT BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1025
Practice Address - Country:US
Practice Address - Phone:215-969-9511
Practice Address - Fax:215-969-9512
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2016-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD043138E207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA707622OtherBLUE SHIELD
PA707622EZ5Medicare PIN
F15130Medicare UPIN