Individual
JENNIFER DELLAGUARDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
826 MAIN ST, SUITE 201, PHOENIXVILLE, PA 19460-4459
(610) 415-1100
(610) 415-1101
Mailing address
826 MAIN ST, SUITE 201, PHOENIXVILLE, PA 19460-4459
(610) 415-1100
(610) 415-1101
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA001519L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
177908
PTAN
PA
01
—
MA001519L
LICENSE
PA
Enumeration date
11/24/2010
Last updated
08/27/2015
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