Jessica A Deluise PA-C

NPI 1073819744 - Physician Assistant - 363AM0700X

NPI Details
NPI 1073819744
Gender Female
Enumeration Date 01/28/2011
Last Updated 01/28/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
2301 S BROAD ST
PHILADELPHIA PA, 19148-3542, US
Phone (215) 951-9000
Fax
Business Location
2201 PENNSYLVANIA AVE
APT. 620
PHILADELPHIA PA, 19130-3513, US
Phone (845) 206-8439
Fax
Toxanomy
Taxonomy Code 363AM0700X
License State Pennsylvania
License Number MA054781
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According to our database, Ms. Jessica A Deluise PA-C NPI is 1073819744, taxonomy code is 363AM0700X and license number is MA054781, license state is located at Pennsylvania. Jessica A Deluise PA-C physically located at 2301 S Broad St, Philadelphia PA, 19148-3542. NPI Number Jessica A Deluise PA-C has the Individual type.

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1073819744 NPI number is provided on an as is basis without warranty of any kind. 1073819744 is maintained by the National Plan & Provider Enumeration System. The contents of Jessica A Deluise PA-C are for informational purposes only.