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General NPI Number Information
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NPI Number | 1417772088
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Entity Type | Individual
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Provider Name | CAMRYN TAYLOR PENN PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 1 ROBERT WOOD JOHNSON PL
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1966
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Country | US
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Telephone | 732-828-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 OLD WYOMISSING RD
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City | READING
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State | PA
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Zip | 19611-1434
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Country | US
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Telephone | 610-451-3399
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 25MP00895200
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License Number State | NJ
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