Individual
JACQUELINE XU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-9990
(215) 243-3297
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-9990
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MT233758
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/13/2021
Last updated
05/01/2025
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