Healthcare Provider Details

I. General information

NPI: 1376715219
Provider Name (Legal Business Name): EDWARD PAUL PHINNEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 CRESCENT AVE
ROCKY HILL NJ
08553-0343
US

IV. Provider business mailing address

PO BOX 343
ROCKY HILL NJ
08553-0343
US

V. Phone/Fax

Practice location:
  • Phone: 609-279-0396
  • Fax:
Mailing address:
  • Phone: 609-279-0396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD434000
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: