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General NPI Number Information
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NPI Number | 1639204225
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Entity Type | Individual
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Provider Name | KIRSTIE R MARCELLO-DONNELLY MD
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 04/23/2021
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Provider Practice Location Address
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Address Line | 111 SOUTH 11TH STREET 7TH FLOOR COLLEGE BUILDING
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City | PHILADELPHIA
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State | PA
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Zip | 19107
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Country | US
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Telephone | 215-955-6523
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Fax |
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Provider Business Mailing Address
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Address Line | 150 NEW JERSEY AVE
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City | COLLINGSWOOD
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State | NJ
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Zip | 08108-1610
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Country | US
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Telephone |
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | MT182361
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License Number State | PA
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