Doctor Name: | MARIANNE KILROY |
NPI Number: | 1043649577 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 582 S Main St Lapeer, MI - 484462467 |
Business Phone Number: | 6108924700 |
Business Fax Number: | 6108929760 |
Mailing Address: | 1400 N Providence Rd, Bldg Ii Suite 1040 MEDIA |
State: | PA |
Postal Code: | 190632043 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/05/2013 |
NPI Last Update Date: | 11/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |