Individual
JESSICA ANN SMUKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1200 W TABOR RD FL 3, PHILADELPHIA, PA 19141-3019
(215) 456-3930
(215) 456-1432
Mailing address
101 E OLNEY AVE STE 400, PHILADELPHIA, PA 19120-2470
(215) 456-1825
(215) 456-5926
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
25MP00158300
NJ
363AM0700X
Medical Physician Assistant
Primary
MA052455
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031903780004
—
PA
Enumeration date
12/13/2006
Last updated
07/16/2021
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