Individual
JESSICA GABRIEL HIRSCHHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
130 S. BRYN MAWR AVE., BRYN MAWR, PA 19010-3121
(610) 526-3000
(302) 651-4945
Mailing address
P.O. BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19723-0191
(302) 651-4000
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002098
CT
363A00000X
Physician Assistant
0110003063
VA
363A00000X
Physician Assistant
013479
NY
363A00000X
Physician Assistant
20394
CA
363A00000X
Physician Assistant
2355-023
WI
363A00000X
Physician Assistant
Primary
MA052626
PA
363AM0700X
Medical Physician Assistant
PA06354
TX
Other
Enumeration date
08/29/2007
Last updated
11/08/2011
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