Individual
JENNIFER MARIE MILLADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 E LEHIGH AVE, CHC-1, PHILA, PA 19125-1012
(215) 707-1866
(215) 707-1876
Mailing address
PO BOX 820933, PHILA, PA 19182-0933
(215) 707-1866
(215) 707-1876
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
TMA052478
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
597586
MEDICARE GROUP
PA
01
—
CD4829
RAILROAD MEDICARE GROUP
PA
Enumeration date
07/29/2011
Last updated
10/24/2013
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