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NPI Code Detail

MEDICARE: CASSANDRA LOUISE KRILL

MEDICARE: CASSANDRA LOUISE KRILL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1285230383
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA LOUISE KRILL
Provider Business Mailing Address
First Line : 4426 OSAGE AVE APT 3F
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-3981
Country : US
Telephone Number : 224-388-8121
Fax Number :
Provider Business Practice Location Address
First Line : 450 S EASTON RD
Second Line :
City : GLENSIDE
State : PA
Zip : 19038-3215
Country : US
Telephone Number : 215-572-2900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2020
Last Update Date : 12/05/2020

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Directions to “ CASSANDRA LOUISE KRILL ” Practice Location

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