Individual
JEANNE M SANDELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1 IRON BRIDGE DR STE 150, COLLEGEVILLE, PA 19426-2058
(484) 622-6320
Mailing address
101 E. OLNEY AVE, PROVIDER ENROLLMENT, SUITE 400, PHILADELPHIA, PA 19120-2421
(215) 254-0403
(215) 456-5926
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS010761L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1423217
BLUE SHIELD
PA
01
—
2108952000
KEYSTONE
PA
01
—
2297175
UNITED HEALTHCARE
PA
01
—
3551485
AETNA
PA
01
—
9253000
CIGNA
PA
01
—
H23831
ELDER CARE
PA
01
—
P00369951
PALMETTO GBA
PA
Enumeration date
10/26/2005
Last updated
03/17/2018
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