Basic Information
| Provider Information | |||||||||
| NPI: | 1326521634 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JIRAS | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | DIANE | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 833 CHESTNUT ST STE 520 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191074430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003219999 | ||||||||
| FaxNumber: | 2673393763 | ||||||||
| Practice Location | |||||||||
| Address1: | 325 PRINCETON AVE | ||||||||
| Address2: | |||||||||
| City: | PRINCETON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085401617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099248183 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2018 | ||||||||
| LastUpdateDate: | 04/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | MA061483 | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 25MP00493200 | NJ | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.