Individual
JACLYN ROSE CAMPANELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 E LANCASTER AVE, WYNNEWOOD, PA 19096-3450
(866) 225-5654
Mailing address
1 LAGOON CT, BRIGANTINE, NJ 08203-1104
(856) 430-4610
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA063048
PA
363A00000X
Physician Assistant
OA005883
PA
Other
Enumeration date
10/06/2021
Last updated
07/24/2025
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