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General NPI Number Information
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NPI Number | 1558165290
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Entity Type | Individual
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Provider Name | KELLY MACDONALD PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 1401 ATLANTIC AVE STE 1000
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City | ATLANTIC CITY
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State | NJ
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Zip | 08401-7025
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Country | US
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Telephone | 609-441-7088
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 ATLANTIC AVE STE 1000
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City | ATLANTIC CITY
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State | NJ
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Zip | 08401-7025
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Country | US
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Telephone | 609-441-7088
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Fax | 609-441-7089
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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 | 28RI03500100
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License Number State | NJ
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