Provider Demographics
NPI:1295775963
Name:MARON, JEFFREY J (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:J
Last Name:MARON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2 DUNDEE MEWS
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-1167
Mailing Address - Country:US
Mailing Address - Phone:610-325-5701
Mailing Address - Fax:610-325-9197
Practice Address - Street 1:144 SNYDER AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-2641
Practice Address - Country:US
Practice Address - Phone:215-336-5566
Practice Address - Fax:215-336-5568
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS003134L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
039281U3VMedicare PIN