Individual
DR. JACQUELINE OWUSU-MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - GENERAL PEDS, PHILADELPHIA, PA 19104-4319
(215) 590-2164
(215) 590-2180
Mailing address
100 E PENN SQ, 9TH FLOOR, PHILADELPHIA, PA 19107-3323
(267) 425-9232
(267) 425-9299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD419509
PA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
MD 419509
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008287050002
—
PA
Enumeration date
07/20/2006
Last updated
07/25/2013
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