Jessica Balella, LDN | |
160 E Erie Ave, Philadelphia, PA 19134-1011 | |
(215) 427-8363 | |
Not Available |
Full Name | Jessica Balella |
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Gender | Female |
Speciality | Dietitian, Registered - Nutrition, Pediatric |
Location | 160 E Erie Ave, Philadelphia, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1205562881 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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133VN1004X | Dietitian, Registered - Nutrition, Pediatric | DN007135 (Pennsylvania) | Primary |
Provider Name | Stc Pediatrics Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1144864547 PECOS PAC ID: 7315372323 Enrollment ID: O20200122001254 |
Mailing Address | Practice Location Address |
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Jessica Balella, LDN Po Box 13579, Reading, PA 19612-3579 Ph: (484) 628-1324 | Jessica Balella, LDN 160 E Erie Ave, Philadelphia, PA 19134-1011 Ph: (215) 427-8363 |
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