JESSE RYAN VICTOR (NPI# 1851738702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851738702 |
| Entity Type | Individual |
| Full Name | JESSE RYAN VICTOR |
| Credential | M.D. |
| Practice Address |
3998 Red Lion Rd Ste 213 Philadelphia PA 19114-1440 |
| Mailing Address |
1600 Sw Archer Rd Room 4102 Gainesville FL 32610-3003 |
| Practice Telephone | 2156125699 |
| Mailing Telephone | 3522650239 |
| Mailing Fax Number | 3522651107 |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2020-10-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | TRN19079 | FL | Allopathic & Osteopathic Physicians |
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
MD462116 | PA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1600 Sw Archer Rd, Room 4102, Gainesville, FL 326103003 | 3522650239 | 3522651107 |
| Street Address |
3998 RED LION RD STE 213 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19114-1440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760617054 | Gentian Toshkezi | Neurological Surgery | 3998 Red Lion Rd Ste 213, Philadelphia, PA 19114 | 2009-05-15 |
| 1770054702 | Laura Elizabeth Ayd | Physician Assistant | 3998 Red Lion Rd Ste 213, Philadelphia, PA 19114-1440 | 2018-12-17 |
| 1386081677 | Christopher Elia | Neurological Surgery | 3998 Red Lion Rd Ste 213, Philadelphia, PA 19114-1440 | 2013-05-28 |
| 1174818850 | Tony Ifechukwude Anene-maidoh | Neurological Surgery | 3998 Red Lion Rd Ste 213, Philadelphia, PA 19114-1440 | 2011-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029906 | Phuoc Nguyen | Nurse Anesthetist, Certified Registered | Jefferson Torresdale Hospital, 10800 Knights Rd, Philadelphia, PA 19114 | 2020-10-05 |
| 1053921932 | Priyanka Patel | Dentist | Philadelphia Dental Smiles, 9140 Academy Road, Philadelphia, PA 19114 | 2020-08-05 |
| 1215419080 | Thomas Patrick Gallagher | Specialist/Technologist | 2708 Ruth Way, Philadelphia, PA 19114 | 2018-08-29 |
| 1558840223 | Alexis Wenger | Early Intervention Provider Agency | 3810 Aubrey Ave, Phila, PA 19114 | 2018-08-13 |
| 1245759232 | Newlands Health | Clinic/Center | 9625 Frankford Ave., Philadelphia, PA 19114 | 2017-09-12 |
| 1619491453 | Nazareth Physician Services Inc | Social Worker | 9815 Roosevelt Blvd Ste G, Philadelphia, PA 19114 | 2017-08-02 |
| 1326561606 | L.s. Share & Love Support Coordinating Agency, LLC | Case Management | 3600 Red Lion Road, Apt 68c, Philadelphia, PA 19114 | 2017-07-19 |
| 1760911952 | Charles C Richards II | Counselor | 2555 Welsh Rd, Apt 407, Philadelphia, PA 19114 | 2017-06-09 |
| 1801338686 | April Neuls | Physical Therapy Assistant | 4213 Lackland Place, Philadelphia, PA 19114 | 2016-11-10 |
| 1114317583 | Siji Cyriac | Physical Therapist | 9501 State Road, Philadelphia, PA 19114 | 2015-01-23 |
| Find all providers in zip 19114 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972060176 | Ncv Diagnostics LLC | Psychiatry & Neurology | 1 Brown St Ste C, Philadelphia, PA 19123-3361 | 2019-02-23 |
| 1982102133 | Sonia Anand-nichols Md PC | Psychiatry & Neurology | 5735 Ridge Ave Ste 101, Philadelphia, PA 19128-1746 | 2018-01-23 |
| 1205357886 | Kenneth Gross | Psychiatry & Neurology | 777 S Broad St Apt 412, Philadelphia, PA 19147-2509 | 2017-07-04 |
| 1417339409 | Leonel Jorge Favio Estofan | Psychiatry & Neurology | 245 N 15th St, 7th Floor, Philadelphia, PA 19102-1200 | 2015-06-25 |
| 1073900700 | Pavan Anil Vaswani | Psychiatry & Neurology | 330 S 9th St Fl 3, Philadelphia, PA 19107-6103 | 2015-04-21 |
| 1942613369 | Mia Chwan Ko | Psychiatry & Neurology | 5401 Old York Rd Ste 404, Philadelphia, PA 19141-3046 | 2014-06-03 |
| 1912340415 | Simy Kabaria Parikh | Psychiatry & Neurology | 900 Walnut St Ste 200, Philadelphia, PA 19107-5191 | 2013-04-15 |
| 1215295118 | Curtis Brandon Allumbaugh | Psychiatry & Neurology | 833 Chestnut St Ste 220, Philadelphia, PA 19107 | 2012-04-27 |
| 1013201870 | Enrique Aradillas Lopez | Psychiatry & Neurology | 1200 Constitution Ave Ste 110, Philadelphia, PA 19112-1323 | 2011-06-08 |
| 1598076358 | Hristelina S. Ilieva | Psychiatry & Neurology | 909 Walnut Street 2nd Floor, Philadelphia, PA 19107-3342 | 2010-06-27 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19114 |
Please comment or provide details below to improve the information on JESSE RYAN VICTOR.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.