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NPI Code Detail

MEDICARE: EMILY DONNELLY I

MEDICARE:   EMILY  DONNELLY I
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityTE010206PA

General Provider Information

NPI Number : 1508267683
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY DONNELLY I
Provider Business Mailing Address
First Line : 212 MARTER AVE
Second Line :
City : MOORESTOWN
State : NJ
Zip : 08057-3114
Country : US
Telephone Number : 856-809-3500
Fax Number : 856-809-3573
Provider Business Practice Location Address
First Line : 212 MARTER AVE
Second Line :
City : MOORESTOWN
State : NJ
Zip : 08057-3114
Country : US
Telephone Number : 856-809-3500
Fax Number : 856-809-3573
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2014
Last Update Date : 09/09/2014

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Directions to “ EMILY DONNELLY I ” Practice Location

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