Individual
HARLA KELLY O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
1600 HADDON AVE RM 122, CAMDEN, NJ 08103-3101
(856) 757-3872
(856) 365-4010
Mailing address
1474 TANYARD ROAD, SUITE A100, SEWELL, NJ 08080-1016
(856) 566-7010
(856) 566-6961
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
25MB10412100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1P9364
MEDICARE PIN
NJ
Enumeration date
06/17/2014
Last updated
06/15/2023
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