NPIMap

Organization Active NPI

Jan N Widerman P.C.

  • Primary Care Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1962657346
Registry record updated Nov 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
OS004029L Issued in PA
Legal business name
JAN N WIDERMAN P.C.
Practice address
10800 Bustleton Ave
Philadelphia, PA 19116-3302
Phone
(215) 934-6777
Fax
(215) 934-6787
NPI assigned
Nov 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jan N. Widerman, DONPI 1023197977
Title
Physician
Phone
(215) 934-6777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X OS004029L PA Primary

Addresses

Primary practice location

10800 Bustleton Ave
Philadelphia, PA 19116-3302

Mailing address

10800 Bustleton Ave
Philadelphia, PA 19116-3302
Phone (215) 934-6777

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227657600000",
    "number": "1962657346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163302",
            "telephone_number": "215-934-6777",
            "fax_number": "215-934-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163302",
            "telephone_number": "215-934-6777",
            "fax_number": "215-934-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAN N WIDERMAN P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-26",
        "last_updated": "2008-11-26",
        "status": "A",
        "authorized_official_last_name": "WIDERMAN",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "215-934-6777",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PA",
            "license": "OS004029L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.