MEDICARE: ANNA JANE DENNERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	F03403	PA

General Provider Information

NPI Number	:	1649572108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA JANE DENNERY

Provider Business Mailing Address
First Line	:	108 S 16TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-2802
Country	:	US
Telephone Number	:	215-563-2402
Fax Number	:	215-563-2135

Provider Business Practice Location Address
First Line	:	108 S 16TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-2802
Country	:	US
Telephone Number	:	215-563-2402
Fax Number	:	215-563-2135

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2010
Last Update Date	:	12/03/2010

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Directions to “ ANNA JANE DENNERY ” Practice Location

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