Doctor Name: | JESSICA ROSE MAYER |
NPI Number: | 1225289549 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DO |
License Number: | OT012663 |
Business Practice Address: | 1437 Dekalb St Suite 101 Norristown, PA - 194013440 |
Business Phone Number: | 6102757240 |
Business Fax Number: | 6102751381 |
Mailing Address: | 1 W Elm St, Suite 100 CONSHOHOCKEN |
State: | PA |
Postal Code: | 194284108 |
Phone Number: | 6105676967 |
Fax Number: | 6105676955 |
NPI Enumeration Date: | 10/06/2008 |
NPI Last Update Date: | 12/20/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | OT012663 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |