Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD014672E | PA |
N | 2080P0208X | Pediatric Infectious Diseases | MD014672E | PA |
NPI | 1245799337 |
---|---|
Provider Name | Jerry Martin Kaplan |
First Address | Philadelphia, PA 19130-2517 |
Second Address | Philadelphia, PA 19130-2517 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2019 |
Last Update Date | 18/03/2019 |