Jeronis, Stacey L

Jeronis, Stacey L is an individual health care provider with primary practice located at 3401 N Broad St 7Th Fl Out Patient Bldg, Philadelphia PA 19140-5103. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Jeronis, Stacey L can be contacted via phone (215) 707-3008.

Contact Information

Primary practice address
3401 N Broad St 7Th Fl Out Patient Bldg Philadelphia PA 19140-5103
Phone: (215) 707-3008
Fax: (215) 707-1387
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MD423048 Pennsylvania

Profile Details

NPI number 1508854704
LBN Legal business name Jeronis, Stacey L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2005
Last updated Mar 21st, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508854704 NPPES
Pennsylvania MEDICAID 1011483010001

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