Individual
DR. JACKELINE IACOVELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2100 KEYSTONE AVE, SUITE 406, DREXEL HILL, PA 19026-1129
(610) 622-8900
(610) 622-8904
Mailing address
2100 KEYSTONE AVE, SUITE 406, DREXEL HILL, PA 19026-1129
(610) 622-8900
(610) 622-8904
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD057529L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001792248
—
PA
Enumeration date
01/31/2007
Last updated
03/21/2012
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