Individual
MRS. JILLO EMMA MASSAQUOI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
110 IRVING ST NW, WASHINGTON, DC 20010-3017
(202) 877-3867
Mailing address
PO BOX 16335, PHILADELPHIA, PA 19114-0435
(215) 969-7510
(215) 969-7513
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA052059
PA
Other
Enumeration date
07/15/2006
Last updated
12/02/2020
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