Provider Demographics
NPI:1790720712
Name:TOBEY, JENNIFER D (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:D
Last Name:TOBEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:1 SILVERSTEIN
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4206
Mailing Address - Country:US
Mailing Address - Phone:215-829-3201
Mailing Address - Fax:215-829-5697
Practice Address - Street 1:800 SPRUCE STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6130
Practice Address - Country:US
Practice Address - Phone:215-829-3201
Practice Address - Fax:215-829-5697
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4198362085R0202X
NJ25MA101099002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019022410003Medicaid
H73173Medicare UPIN
PA063974Medicare ID - Type Unspecified