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NPI Code Detail

MEDICARE: JESSICA OCAVA PA

MEDICARE: JESSICA OCAVA PA
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 AssistantMA052378PA
2363AS0400XSurgical Physician Assistant

General Provider Information

NPI Number : 1588728406
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA OCAVA PA
Provider Business Mailing Address
First Line : 925 CHESTNUT ST
Second Line : DPT OF OTORHINOLARGYNGOLOGY 6TH FLOOR
City : PHILA
State : PA
Zip : 19107-4216
Country : US
Telephone Number : 215-955-6760
Fax Number : 215-294-1142
Provider Business Practice Location Address
First Line : 925 CHESTNUT ST
Second Line : DPT OF OTORHINOLARGYNGOLOGY 6TH FLOOR
City : PHILA
State : PA
Zip : 19107-4216
Country : US
Telephone Number : 215-955-6760
Fax Number : 215-294-1142
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2006
Last Update Date : 01/12/2016

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Directions to “ JESSICA OCAVA PA” Practice Location

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