Individual
CECILEY MARIE JEANETTE BLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO, MPH
Contact information
Practice address
2601 HOLME AVE, PHILADELPHIA, PA 19152-2007
(267) 350-7401
Mailing address
2601 HOLME AVE, PHILADELPHIA, PA 19152-2007
(267) 350-7401
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
PA
Other
Enumeration date
03/24/2023
Last updated
03/28/2023
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