Owusu-Mckenzie, Jacqueline

Owusu-Mckenzie, Jacqueline is an sole proprietor health care provider with primary practice located at 3401 Civic Center Blvd Children'S Hospital Of Philadelphia - General Peds, Philadelphia PA 19104-4319. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Owusu-Mckenzie, Jacqueline can be contacted via phone (215) 590-2164.

Contact Information

Primary practice address
3401 Civic Center Blvd Children'S Hospital Of Philadelphia - General Peds Philadelphia PA 19104-4319
Phone: (215) 590-2164
Fax: (215) 590-2180
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD419509 Pennsylvania
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X MD 419509 Pennsylvania

Profile Details

NPI number 1730109950
LBN Legal business name Owusu-Mckenzie, Jacqueline
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 20th, 2006
Last updated Jul 25th, 2013 - about 11 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 1730109950 NPPES
Pennsylvania MEDICAID 1008287050002

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