Basic Information
| Provider Information | |||||||||
| NPI: | 1639129976 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CONNELL | ||||||||
| FirstName: | JOANNE | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 829641 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191820001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2673705296 | ||||||||
| FaxNumber: | 2152303725 | ||||||||
| Practice Location | |||||||||
| Address1: | 1456 FERRY ROAD | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | FOUNTAINVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152308390 | ||||||||
| FaxNumber: | 2152308392 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2006 | ||||||||
| LastUpdateDate: | 10/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD-426360 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.