Individual
ELISSA MARIE DEVENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
142 S 52ND ST, PHILADELPHIA, PA 19139-3409
(215) 471-4000
Mailing address
142 S 52ND ST STE 201, PHILADELPHIA, PA 19139-3409
(215) 471-4000
(215) 471-4001
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
28RI04023100
NJ
183500000X
Pharmacist
Primary
RP452580
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104292130-0001
—
PA
Enumeration date
01/02/2020
Last updated
03/28/2024
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