Jaclyn Cullen

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC010066 Issued in PA

Practice address

690 Vernon Rd
Springfield, PA 19064-2020

Phone

(610) 368-6413

NPI assigned

Jun 15, 2011

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

• Jaclyn Quercetti Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 6, 2017.

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1215222575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 VERNON RD",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 VERNON RD",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642020",
            "telephone_number": "610-368-6413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "JACLYN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00518200",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC010066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "QUERCETTI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Crozer-Chester Medical Center
• Crozer-Chester Medical Center
• Crozer-Chester Medical Center
• Crozer-Keystone Health System
• Georgia Crozier, OD
• Francine T Cwyk, D.M.D.
• Gemma Nicole D'Angelo, CRNP
• Michael P D'Angelo
• Lisa Ann D'Arcy, PT
• Alexa Da Luz Vani

• All providers in Springfield, PA
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.