Most Relevant Information
Provider Data
| NPI Number: | 1003301920 |
| Provider Name: | JOHANNA MARIE FARINELLA NURSE PRACTITIONER |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | AG04180018 |
Most Important Dates
| Enumeration Date: | 06/22/2018 |
| Last Updated: | 06/22/2018 |
Provider Practice Location
9501 ROOSEVELT BLVD
PHILADELPHIA
PA
191141025
Practice Location Phone/Fax
| Phone: | 2156735000 |
| Fax: |
Provider Mailing Location
1870 AUGUST DR
HUNTINGDON VALLEY
PA
190061511
Provider Mailing Phone/Fax
| Phone: | 2153222852 |
| Fax: |