Individual provider · Type 1 NPI
Carly Jean Coulombe
Medical Physician Assistant · Philadelphia, PA
NPI number
1912878091
Active
Practice location
3900 Woodland Ave
Philadelphia, PA 19104-4551
Mailing address
240 E Girard Ave Unit 1
Philadelphia, PA 19125-3929
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | None listed |
Medical Physician Assistant: Definition to come...
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About NPI 1912878091
Carly Jean Coulombe's National Provider Identifier is 1912878091, issued on Sep 13, 2025. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Philadelphia, PA. The record was last updated on Sep 25, 2025.