Healthcare Provider Details

I. General information

NPI: 1235188202
Provider Name (Legal Business Name): KARA GASINK JOLLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARA TOWNSEND GASINK M.D.

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 04/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W BUTLER AVE
CHALFONT PA
18914-2219
US

IV. Provider business mailing address

100 E PENN SQ 6TH FLOOR WANAMAKER BUILDING
PHILADELPHIA PA
19107-3323
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-6267
  • Fax:
Mailing address:
  • Phone: 215-590-6267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD454781
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: