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Individual

JESSICA CERASOLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
219 N BROAD ST, PHILADELPHIA, PA 19107-1519
(215) 762-6620
Mailing address
169 GREENWOOD AVE, APT. B5, JENKINTOWN, PA 19046-2626
(724) 561-3313

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
C5-0001284
DE
363AM0700X
Medical Physician Assistant
Primary
MA058021
PA

Other

Enumeration date
12/14/2015
Last updated
06/21/2021
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