Basic Information
Provider Information
NPI: 1073774857
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MOST
FirstName: JESSICA
MiddleName: FREYER
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: FREUER
OtherFirstName: JESSICA
OtherMiddleName: ERIN
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: 1601 CHERRY ST
Address2: SUITE 11511
City: PHILADELPHIA
State: PA
PostalCode: 191021321
CountryCode: US
TelephoneNumber: 2157622688
FaxNumber: 2157622689
Practice Location
Address1: 834 WALNUT ST STE 650
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191075109
CountryCode: US
TelephoneNumber: 2159555161
FaxNumber: 2159236003
Other Information
ProviderEnumerationDate: 06/24/2008
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XMD438659PAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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