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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208000000X | Pediatrics | MD448416 | PA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PA | 1032348390001 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
111 S 11th St, Suite 2170, Philadelphia, PA 191074824 | 2155034053 |
Street Address |
3550 MARKET ST |
City | PHILADELPHIA |
State | PA |
Zip Code | 19104 |
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 |
Find all providers in the same location |
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 Code | 208000000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
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. |
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 |
Find all providers in PHILADELPHIA |
City | PHILADELPHIA |
Zip Code | 19104 |
Please comment or provide details below to improve the information on CARISSA ROSE JACKEL.
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.