Individual
DR. KELLI MAYO DANOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
525 ROUTE 73 S STE 305A, MARLTON, NJ 08053-9644
(856) 420-6070
(870) 890-4610
Mailing address
525 ROUTE 73 S STE 305A, MARLTON, NJ 08053-9644
(856) 420-6070
(870) 890-4610
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MB09622700
NJ
207N00000X
Dermatology Physician
OS018143
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508155300
NPI
—
01
—
25MB09622700
STATE LICENSE
NJ
01
—
OS018143
STATE LICENSE
PA
01
—
P01701913
RAILROAD MEDICARE
PA
Enumeration date
04/01/2011
Last updated
03/16/2021
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