Gibbons, Jacquelyn H
Gibbons, Jacquelyn H is an individual health care provider with primary practice located at 100 Granite Dr Suite 200, Media PA 19063-5134. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Gibbons, Jacquelyn H can be contacted via phone (610) 565-1945.Contact Information
Primary practice address
100 Granite Dr Suite 200
Media PA 19063-5134
Phone: (610) 565-1945
Fax: (610) 892-7848
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD006608E | Pennsylvania |
Profile Details
| NPI number | 1013971605 |
|---|---|
| LBN Legal business name | Gibbons, Jacquelyn H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 12th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1013971605 | NPPES |
| Pennsylvania | MEDICAID | 0764795 |
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