Individual
DANIELLE BOATENG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(800) 836-7536
Mailing address
1504 FAIRMOUNT AVE APT C, PHILADELPHIA, PA 19130-2951
(410) 627-0569
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MT226400
PA
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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