Basic Information
| Provider Information | |||||||||
| NPI: | 1982693446 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TONER | ||||||||
| FirstName: | DE'SHON | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 728 CONSHOHOCKEN STATE RD | ||||||||
| Address2: | |||||||||
| City: | PENN VALLEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190721438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6092210449 | ||||||||
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| Practice Location | |||||||||
| Address1: | 34TH AND CIVIC CENTER BOULEVARD | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155903440 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2005 | ||||||||
| LastUpdateDate: | 12/22/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0200X | SPOO8466 | PA | Y | Nursing Service Providers | Registered Nurse | Pediatrics |
No ID Information.