Individual
MARY O'DONNELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 ROUTE 9 N, SUITE 302, WOODBRIDGE, NJ 07095-1215
(732) 634-0036
(732) 855-9395
Mailing address
1000 ROUTE 9 N, SUITE 302, WOODBRIDGE, NJ 07095-1215
(732) 634-0036
(732) 855-9395
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA65838
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8222100
—
NJ
01
—
873097
AETNA
—
01
—
K5409
HORIZON BLUE SHIELD
NJ
Enumeration date
01/27/2006
Last updated
07/08/2007
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