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General NPI Number Information
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NPI Number | 1558414979
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Entity Type | Individual
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Provider Name | MARYANN BUCKLEY PHINNEY MD
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Gender | Female
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 419 N HARRISON ST
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City | PRINCETON
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State | NJ
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Zip | 08540-3594
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Country | US
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Telephone | 609-924-9300
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Fax | 609-430-9481
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Provider Business Mailing Address
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Address Line | 6645 UPPER YORK ROAD #543
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City | SOLEBURY
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State | PA
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Zip | 18963
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Country | US
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Telephone | 267-293-0495
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 25MA08098200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD450286
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License Number State | PA
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