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Carmel M Odonnell
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NPI Number Detailed Information
Provider Information:
Name: | Carmel M Odonnell |
Gender: | F |
Provider License Number If Given: | 25MB08097600 |
NPI Information:
NPI: | 1497754097 |
Entity Type (Individual or Organization): |
1-ind |
Enumeration Date: | 7/18/2005 |
Last Update Date: | 2/6/2013 |
Provider Business Mailing Address:
Address: | 410 N BROADWAY SUITE 1 Pitman, NJ 08071 |
Phone Number: | 8565893708 |
Fax Number: | 8565892662 |
Provider Business Practice Location Address:
Address: | 410 N BROADWAY SUITE 1 Pitman, NJ 08071 |
Phone Number: | 8565893708 |
Fax Number: | 8565892662 |
Provider Taxonomy:
Primary: | 207R00000X |
Secondary (if any): | |
State: | NJ |