BAE JAE - NPI: 1154643187


Mood disorder is a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders classification system where a disturbance in the person's mood is hypothesized to be the main underlying feature. The classification is known as mood (affective) disorders in International Classification of Diseases (ICD).

NPI: 1154643187
Entity Type: Person: individual human being who furnishes health care.
Provider First Name: JAE
Provider Last Name: BAE
Provider Gender Code: M
Provider Credential Text: PHARMD
Provider Enumeration Date: 02/18/2010
Last Update Date: 11/06/2018

Business Address:

Provider First Line Business Mailing Address: 2137 E CHELTEN AVE
Provider Business Mailing Address City Name: PHILADELPHIA
Provider Business Mailing Address State Name: PA
Provider Business Mailing Address Postal Code: 19138
Provider Business Mailing Address Country Code (If outside U.S.): US
Phone: 1554852212
Fax Number: 2155485386

Mailing Address:

Provider First Line Business Practice Location Address: 2137 E CHELTEN AVE
Provider Business Practice Location Address City Name: PHILADELPHIA
Provider Business Practice Location Address State Name: PA
Provider Business Practice Location Address Postal Code: 19138
Provider Business Practice Location Address Country Code (If outside U.S.): US
Phone: 2155485221
Fax Number: 2155485386

Primary Taxonomy:

Taxonomy Code: 183500000X
License Number: RP438777
License State: PA
Healthcare Provider Primary Taxonomy Switch: Y - The taxonomy is the primary taxonomy (there can be only one per NPI record
Type: Pharmacy Service Providers
Classification: Pharmacist
Definition: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes
Taxonomy Description: but is not limited to
Source: The National Provider Identifier

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1063950376 PRODIGY HOME CARE