Healthcare Provider Details

I. General information

NPI: 1396134821
Provider Name (Legal Business Name): ALANNA O'CONNELL D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2015
Last Update Date: 06/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 SANSOM ST STE 239
PHILADELPHIA PA
19107-5002
US

IV. Provider business mailing address

1020 SANSOM ST STE 239
PHILADELPHIA PA
19107-5002
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-6844
  • Fax: 215-955-2526
Mailing address:
  • Phone: 215-955-6844
  • Fax: 215-955-2526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS019806
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: