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General NPI Number Information
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NPI Number | 1497098537
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Entity Type | Individual
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Provider Name | JESSICA ANN BRISCOE M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/27/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3401 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5103
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Country | US
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Telephone | 215-707-5734
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 DAY ST
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City | PHILADELPHIA
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State | PA
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Zip | 19125-3903
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Country | US
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Telephone | 301-706-3854
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Fax |
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 25MA10868100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0081538
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License Number State | MD
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