Active NPI
Joel B Jurnovoy, MD
- Dermatology Physician
- Havertown, PA
National Provider Identifier
1023104544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD010163E
- Practice address
- 2010 West Chester Pike
Suite 350
Havertown, PA 19083-2738 - Phone
- (610) 924-0135
- Fax
- (610) 924-0620
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MD010163E | PA | Primary |
Addresses
Primary practice location
2010 West Chester Pike
Suite 350
Havertown, PA 19083-2738
Mailing address
3656 Waynesfield Drive
Newtown Square, PA 19073
Phone (610) 353-6463
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD010163E | Other | PA | LICENSE |
| 0031679000 | Other | PA | 081671 IBC PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD010163E | PA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1023104544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3656 WAYNESFIELD DRIVE",
"city": "NEWTOWN SQUARE",
"state": "PA",
"postal_code": "19073",
"telephone_number": "610-353-6463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 WEST CHESTER PIKE",
"address_2": "SUITE 350",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "190832738",
"telephone_number": "610-924-0135",
"fax_number": "610-924-0620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JURNOVOY",
"first_name": "JOEL",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "PA",
"license": "MD010163E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "MD010163E",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "081671 IBC PROVIDER #",
"identifier": "0031679000",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Havertown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.