Individual
JUDITH G MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 SPRUCE STREET, GROUND SILVERSTEIN BLDG, PHILADELPHIA, PA 19104
(215) 662-4439
Mailing address
3400 SPRUCE ST, GROUND SILVERSTEIN BLDG, PHILADELPHIA, PA 19104-4206
(215) 662-4439
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD062688L
PA
2083X0100X
Occupational Medicine Physician
Primary
MD062688L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016516700005
—
PA
Enumeration date
06/30/2006
Last updated
04/11/2014
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