Healthcare Provider Details

I. General information

NPI: 1659297653
Provider Name (Legal Business Name): ANTHONY EDWARD HOLLIDAY JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 CIVIC CENTER BLVD
PHILADELPHIA PA
19104-4319
US

IV. Provider business mailing address

1928 W HIGH ST
HADDON HEIGHTS NJ
08035-1110
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN589657
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: