Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DS041104 | PA |
NPI | 1265601272 |
---|---|
Provider Name | Dr. Jeffrey M Rodney |
First Address | Philadelphia, PA 19140-5007 |
Second Address | Philadelphia, PA 19140-5007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2008 |
Last Update Date | 01/10/2019 |