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General NPI Number Information
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NPI Number | 1427242775
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Entity Type | Individual
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Provider Name | JESSICA GABRIEL HIRSCHHORN PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 11/08/2011
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Provider Practice Location Address
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Address Line | 130 S. BRYN MAWR AVE.
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City | BRYN MAWR
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State | PA
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Zip | 19010-3121
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Country | US
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Telephone | 610-526-3000
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Fax | 302-651-4945
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Provider Business Mailing Address
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Address Line | P.O. BOX 191 PROVIDER ENROLLMENT DEPT
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City | ROCKLAND
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State | DE
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Zip | 19723-0191
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Country | US
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Telephone | 302-651-4000
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Fax | 302-651-4945
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA052626
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 002098
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110003063
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 20394
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 013479
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2355-023
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License Number State | WI
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Taxonomy #7
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA06354
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License Number State | TX
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