Healthcare Provider Details

I. General information

NPI: 1174787832
Provider Name (Legal Business Name): LOVELLE MCFADDEN-PARSI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 05/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 MCCLELLAN AVE SUITE B201
PENNSAUKEN NJ
08109-4683
US

IV. Provider business mailing address

500 GROVE ST SUITE 100
HADDON HEIGHTS NJ
08035-1761
US

V. Phone/Fax

Practice location:
  • Phone: 856-330-6300
  • Fax: 856-330-6305
Mailing address:
  • Phone: 856-796-9255
  • Fax: 856-796-9397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MB08446900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: