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General NPI Number Information
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NPI Number | 1871675322
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Entity Type | Individual
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Provider Name | MARY KATHERINE POWDERLY MD, FACOG, AAAAM
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Gender | Female
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 02/17/2019
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Provider Practice Location Address
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Address Line | 32 WORLDS FAIR DR STE 201
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City | SOMERSET
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State | NJ
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Zip | 08873-1388
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Country | US
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Telephone | 732-356-1266
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Fax | 732-356-1196
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Provider Business Mailing Address
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Address Line | 19 HUNTERS CROSSING RD
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City | SOMERSET
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State | NJ
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Zip | 08873-7706
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Country | US
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Telephone | 732-873-1843
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Fax | 732-873-8977
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 25MA04685500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 25MA04685500
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License Number State | NJ
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