Iacovella, Jackeline

Iacovella, Jackeline is an individual health care provider with primary practice located at 2100 Keystone Ave Suite 406, Drexel Hill PA 19026-1129. She recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as her primary health care specialty. Iacovella, Jackeline can be contacted via phone (610) 622-8900.

Contact Information

Primary practice address
2100 Keystone Ave Suite 406 Drexel Hill PA 19026-1129
Phone: (610) 622-8900
Fax: (610) 622-8904
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X MD057529L Pennsylvania

Profile Details

NPI number 1174660195
LBN Legal business name Iacovella, Jackeline
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2007
Last updated Mar 21st, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174660195 NPPES
Pennsylvania MEDICAID 001792248

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