Doctor Name: | JENNIFER ROSE DRUCK |
NPI Number: | 1013970896 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PAC |
License Number: | MA051709 |
Business Practice Address: | 141 E Emaus Ave Allentown, PA - 181035824 |
Business Phone Number: | 6107915930 |
Business Fax Number: | 6107912157 |
Mailing Address: | Po Box 783311, PHILADELPHIA |
State: | PA |
Postal Code: | 191783311 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/11/2006 |
NPI Last Update Date: | 09/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | MA051709 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |