Provider Demographics
NPI:1366415267
Name:CAJULIS, JINN WIEN (MD)
Entity type:Individual
Prefix:DR
First Name:JINN WIEN
Middle Name:
Last Name:CAJULIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JINN WIEN
Other - Middle Name:
Other - Last Name:CAJULIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1338 BRISTOL PIKE STE 202
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-5679
Mailing Address - Country:US
Mailing Address - Phone:215-632-5437
Mailing Address - Fax:215-824-4114
Practice Address - Street 1:1338 BRISTOL PIKE STE 202
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-5679
Practice Address - Country:US
Practice Address - Phone:215-632-5437
Practice Address - Fax:215-824-4114
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426695208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018554580002Medicaid