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General NPI Number Information
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NPI Number | 1033244850
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Entity Type | Individual
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Provider Name | JUEL R. NALL MD
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 04/26/2011
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Provider Practice Location Address
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Address Line | 5044 SPRUCE ST MEDNET HEALTHCARE SYSTEMS
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City | PHILADELPHIA
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State | PA
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Zip | 19139-4115
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Country | US
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Telephone | 215-474-4410
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Fax | 215-474-4410
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Provider Business Mailing Address
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Address Line | 5044 SPRUCE ST MEDNET HEALTHCARE SYSTEMS
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City | PHILADELPHIA
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State | PA
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Zip | 19139-4115
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Country | US
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Telephone | 215-474-4410
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Fax | 215-474-4418
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD070387L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD070387L
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License Number State | PA
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