Carrasco, Jacqueline R
Carrasco, Jacqueline R is an individual health care provider with primary practice located at 100 E Lancaster Ave Ste 54 , Wynnewood PA 19096-3438. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery is her primary health care specialty. Carrasco, Jacqueline R can be contacted via phone (610) 649-1970.Contact Information
Primary practice address
100 E Lancaster Ave Ste 54
Wynnewood PA 19096-3438
Phone: (610) 649-1970
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | MD416985 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 25MA07455900 | New Jersey |
| Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery | 207WX0200X | MD416985 | Pennsylvania |
Profile Details
| NPI number | 1336148410 |
|---|---|
| LBN Legal business name | Carrasco, Jacqueline R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2005 |
| Last updated | Jul 28th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336148410 | NPPES |
| Pennsylvania | MEDICAID | 101226829001 |
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