Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD436192 | PA |
NPI | 1295917664 |
---|---|
Provider Name | Jeffrey Luebbert |
First Address | Philadelphia, PA 19106-3500 |
Second Address | Philadelphia, PA 19106-3500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2007 |
Last Update Date | 17/09/2019 |