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General NPI Number Information
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NPI Number | 1174775340
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Entity Type | Individual
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Provider Name | MARCELINE ANGELA FITZWILLIAM PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/18/2008
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Last Update Date | 10/18/2008
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Provider Practice Location Address
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Address Line | 730 MARKET ST
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City | PHILADELPHIA
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State | PA
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Zip | 19106-2312
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Country | US
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Telephone | 215-627-6433
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Fax | 215-627-6408
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Provider Business Mailing Address
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Address Line | 6431 MORRIS PARK RD
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City | PHILADELPHIA
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State | PA
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Zip | 19151-2404
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Country | US
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Telephone | 215-627-6433
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Fax | 215-627-6406
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP438870
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License Number State | PA
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