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1093252538
JACQUELYN RUSSO
PHILADELPHIA, PA
NPI
1093252538
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
282NC2000X General Acute Care Hospital, Children
(Licence: PA SP016464)
Enumeration Date
2017-01-23
Last Update Date
2017-01-24
Business Address
-- JACQUELYN RUSSO
160 E ERIE AVE
PHILADELPHIA, PA 19134-1011
Phone number: 215-427-5000
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Mailing Address
-- JACQUELYN RUSSO
2530 S MOLE ST
PHILADELPHIA, PA 19145-4606
Phone number: 484-477-9599
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