CARISSA ROSE JACKEL


Address: 3550 Market St, Philadelphia, PA 19104
Phone: 2155901000

CARISSA ROSE JACKEL (NPI# 1295051654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1295051654
Entity Type Individual
Full Name CARISSA ROSE JACKEL
Practice Address 3550 Market St
Philadelphia
PA 19104
Mailing Address 100 Penn Square East
9th Floor North Tower
Philadelphia
PA 19107
Practice Telephone 2155901000
Practice Fax Number 2155904844
Mailing Telephone 2674259200
Mailing Fax Number 2674259299
Enumeration Date 2010-04-10
Last Update Date 2018-11-21
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208000000X Pediatrics MD448416 PA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
PA 1032348390001 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
111 S 11th St, Suite 2170, Philadelphia, PA 191074824 2155034053

Office Location

Street Address 3550 MARKET ST
City PHILADELPHIA
State PA
Zip Code 19104

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932182300 Andrea Rene Bailer Nurse Practitioner 3550 Market St, 4th Floor Adolescent Care Center, Philadelphia, PA 19104-3329 2005-11-21
1295371961 Erica Rand Social Worker 3550 Market St, Philadelphia, PA 19104-3329 2019-11-18
1306481262 Julianne Larner Case Manager/Care Coordinator 3550 Market St, Philadelphia, PA 19104-3329 2019-11-14
1760953160 On Demand Urgent Care Group PC Clinic/Center 3550 Market St, Philadelphia, PA 19104-3329 2018-12-10
1205290970 Tcm Adolescent Initiative and Family Care Center Social Worker 3550 Market St, 5th Floor, Philadelphia, PA 19104-3329 2016-04-08
1770926206 Sandhyaa Sudha Iyengar Pediatrics 3550 Market St, Philadelphia, PA 19104-3329 2013-04-15
1851680888 Gita Ram Allergy & Immunology 3550 Market St, Chop Care Network @ Market St - Allergy & Immunology, Philadelphia, PA 19104-3329 2011-03-30
1497077440 Megan Ott Lewis Nurse Practitioner 3550 Market St, Rm 30249, Philadelphia, PA 19104-3329 2010-02-18
1932430063 Susan Bakewell Sachs Registered Nurse 3550 Market St, Philadelphia, PA 19104-3329 2010-01-29
1831428093 Carrie Lynn Calabrese Nurse Practitioner 3550 Market St, 4th Floor - Adolescent Care Center, Philadelphia, PA 19104-3329 2009-12-17
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1639770829 Michelle Morris Student in an Organized Health Care Education/Training Program Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 2020-11-04
1346853041 Spectrum Health Services, Inc. Clinic/Center 1415 South University Ave, Philadelphia, PA 19104 2020-08-24
1770104259 Fatimah Sorefan-mangou Student in an Organized Health Care Education/Training Program 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 2020-05-06
1114548690 Rebecca Blaguski Registered Nurse The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 2020-05-06
1952944175 Rebecca Miriam Barmherzig Psychiatry & Neurology 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 2019-10-21
1891257101 James Paul Byrne Surgery Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 2019-04-04
1093276453 Lauren Shreve Student in an Organized Health Care Education/Training Program Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 2019-03-28
1285194282 Lauren M Christie Student in an Organized Health Care Education/Training Program Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 2019-03-25
1114487683 Sabrina Layne Student in an Organized Health Care Education/Training Program 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 2019-03-21
1811457310 Kia Lor Student in an Organized Health Care Education/Training Program Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 2019-03-21
Find all providers in zip 19104

Taxonomy Information

Taxonomy Code 208000000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics

Taxonomy Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861036279 Stc Pediatrics LLC Pediatrics 300 E Hunting Park Ave, Philadelphia, PA 19124-6018 2019-10-30
1447818729 Elizabeth Edmondston Tarr Pediatrics 3401 Civic Center Blvd Fl 9nw55, Philadelphia, PA 19104-4319 2019-06-03
1245799337 Jerry Martin Kaplan Pediatrics 2421 Fairmount Ave, Philadelphia, PA 19130-2517 2019-03-18
1992299861 Gayathri Prabhakar Pediatrics 3401 Civic Center Blvd 9nw, Rm 55, Philadelphia, PA 19104-4319 2018-06-14
1992298004 Daniel Rappoport Pediatrics 3401 Civic Center Boulevard, 9nw, Room 55, Philadelphia, PA 19104-4399 2018-06-13
1376069567 Childrens Hospital of Philadelphia Pediatrics 3401 Civic Center Blvd Fl 4, Philadelphia, PA 19104-4319 2017-08-18
1558881581 Isabel Cristina Castillo Hernandez Pediatrics 4500-10, Apt 201b, Philadelphia, PA 19124 2017-06-21
1891225694 Joshua Hruby Sperling Pediatrics 3401 Civic Center Boulevard 9nw, Room 55, The Children's Hospital of Philadelphia, Philadelphia, PA 19104-4399 2017-06-14
1124558911 Salvatore Charles Rametta Pediatrics 3401 Civic Center Boulevard Building 9nw Room 55, Children's Hospital of Philadelphia, Philadelphia, PA 19104 2017-06-14
1922536952 Alyssa Coffin Pediatrics 3401 Civic Center Blvd Fl 9nw, Philadelphia, PA 19104-4319 2017-06-03
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Competitor

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City PHILADELPHIA
Zip Code 19104

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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