Healthcare Provider Details

I. General information

NPI: 1508806647
Provider Name (Legal Business Name): FELICIA M BOOKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FELICIA M CONNELLY

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 HARDING HWY STE 6
MAYS LANDING NJ
08330-2243
US

IV. Provider business mailing address

401 ROUTE 73 N BLDG 10, SUITE 320
MARLTON NJ
08053
US

V. Phone/Fax

Practice location:
  • Phone: 609-625-8585
  • Fax: 609-625-3415
Mailing address:
  • Phone: 609-625-8585
  • Fax: 609-625-3415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD068653L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA06550600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: