Provider Demographics
NPI:1457649238
Name:NEUBERT, JACKIE LEE (DO)
Entity Type:Individual
Prefix:DR
First Name:JACKIE
Middle Name:LEE
Last Name:NEUBERT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8 HARVIN RD
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-1506
Mailing Address - Country:US
Mailing Address - Phone:607-738-1854
Mailing Address - Fax:
Practice Address - Street 1:245 N 15TH ST # MS 310
Practice Address - Street 2:HAHNEMANN UNIVERSITY HOSPITAL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1101
Practice Address - Country:US
Practice Address - Phone:215-762-7922
Practice Address - Fax:216-762-8656
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY279593-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology