Jantzen, Ellen C

Jantzen, Ellen C is an individual health care provider with primary practice located at 34Th Street & Civic Center Blvd Suite 9329, Philadelphia PA 19104. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pediatric Anesthesiology. Allopathic & Osteopathic Physicians / Pediatric Anesthesiology is her primary health care specialty. Jantzen, Ellen C can be contacted via phone (215) 590-1858.

Contact Information

Primary practice address
34Th Street & Civic Center Blvd Suite 9329 Philadelphia PA 19104
Phone: (215) 590-1858
Fax: (215) 590-1415
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X MD028119E Pennsylvania
Allopathic & Osteopathic Physicians / Pediatric Anesthesiology 207LP3000X MD028119E Pennsylvania

Profile Details

NPI number 1881709103
LBN Legal business name Jantzen, Ellen C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2006
Last updated Apr 11th, 2013 - about 11 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 1881709103 NPPES
Pennsylvania MEDICAID 0009399530
Pennsylvania Other 212585EJL

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