Individual
DR. JENNIFER MARY AVALLONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
550 S GODDARD BLVD, KING OF PRUSSIA, PA 19406-2922
(215) 590-1719
Mailing address
550 S GODDARD BLVD, KING OF PRUSSIA, PA 19406-2922
(215) 590-1719
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
OS021729
PA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
OS021729
PA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
OS14496
FL
2084N0600X
Clinical Neurophysiology Physician
OS021729
PA
2084N0600X
Clinical Neurophysiology Physician
Primary
OS14496
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OS14496
STATE OF FLORIDA DEPT OF HEALTH
FL
Enumeration date
12/24/2008
Last updated
03/07/2022
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