Healthcare Provider Details

I. General information

NPI: 1811133887
Provider Name (Legal Business Name): JAIMIE ZARRELLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2008
Last Update Date: 12/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 ARCH ST
PHILADELPHIA PA
19107-3002
US

IV. Provider business mailing address

1216 ARCH ST 6TH FLOOR
PHILADELPHIA PA
19107-2835
US

V. Phone/Fax

Practice location:
  • Phone: 267-940-5500
  • Fax:
Mailing address:
  • Phone: 267-940-5500
  • Fax: 215-207-0640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: