=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174787832
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LOVELLE MCFADDEN-PARSI D.O.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/11/2008
-----------------------------------------------------
Last Update Date | 05/19/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2475 MCCLELLAN AVE SUITE B201
-----------------------------------------------------
City | PENNSAUKEN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08109-4683
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-330-6300
-----------------------------------------------------
Fax | 856-330-6305
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 500 GROVE ST SUITE 100
-----------------------------------------------------
City | HADDON HEIGHTS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08035-1761
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-796-9255
-----------------------------------------------------
Fax | 856-796-9397
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 25MB08446900
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------