Individual
KATELYNN SUZANNE OBRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4190 CITY AVE, PHILADELPHIA, PA 19131-1626
(215) 871-6763
Mailing address
457 HADDONFIELD RD STE 110, CHERRY HILL, NJ 08002-2223
(844) 542-2273
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00589500
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/31/2019
Last updated
02/02/2021
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