Provider Demographics
NPI:1346390051
Name:MCCARDELL, JESSICA GASCHO (DO)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:GASCHO
Last Name:MCCARDELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1059 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3130
Mailing Address - Country:US
Mailing Address - Phone:717-397-7085
Mailing Address - Fax:717-390-2584
Practice Address - Street 1:1059 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3130
Practice Address - Country:US
Practice Address - Phone:717-397-7085
Practice Address - Fax:717-390-2584
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013152207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology