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1568857084
JONATHAN IAN LAKE
PHILADELPHIA, PA
NPI
1568857084
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology
(Licence: PA MD472772)
Enumeration Date
2015-04-01
Last Update Date
2022-03-10
Business Address
Dr. JONATHAN IAN LAKE M.D.
3400 SPRUCE ST 100 CENTREX
PHILADELPHIA, PA 19104-4238
Phone number: 215-662-2200
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Mailing Address
Dr. JONATHAN IAN LAKE M.D.
3400 SPRUCE ST
PHILADELPHIA, PA 19104-4238
Phone number: 215-662-2200
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