Basic Information
Provider Information
NPI: 1497968176
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CONFINO
FirstName: JOCELYN
MiddleName: M.
NamePrefix: MRS.
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 933 E HAVERFORD RD
Address2:  
City: BRYN MAWR
State: PA
PostalCode: 190103819
CountryCode: US
TelephoneNumber: 6105273800
FaxNumber: 6105270334
Practice Location
Address1: 933 E HAVERFORD RD
Address2:  
City: BRYN MAWR
State: PA
PostalCode: 190103819
CountryCode: US
TelephoneNumber: 6105273800
FaxNumber: 6105270334
Other Information
ProviderEnumerationDate: 05/08/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700XMA051439PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

ID Information
IDTypeStateIssuerDescription
MA05143901PAPHYS. ASSISTANTOTHER


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