Basic Information
| Provider Information | |||||||||
| NPI: | 1508866294 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAMPHERSTEIN | ||||||||
| FirstName: | JILL | ||||||||
| MiddleName: | CHRISTINE | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1047 OLD YORK RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190014617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2158861240 | ||||||||
| FaxNumber: | 2158867591 | ||||||||
| Practice Location | |||||||||
| Address1: | 1047 OLD YORK RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190014617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2158861240 | ||||||||
| FaxNumber: | 2158867591 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | MA050790 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.