Pennycooke, Shelley Ann Nicole

Pennycooke, Shelley Ann Nicole is an sole proprietor health care provider with primary practice located at 18 E Laurel Rd , Stratford NJ 08084-1327. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Pennycooke, Shelley Ann Nicole can be contacted via phone (856) 346-7985.

Contact Information

Primary practice address
18 E Laurel Rd Stratford NJ 08084-1327
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X PRACTICING New Jersey

Profile Details

NPI number 1821297938
LBN Legal business name Pennycooke, Shelley Ann Nicole
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2007
Last updated Dec 14th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821297938 NPPES
New Jersey Other P00766006 RR MEDICARE
New Jersey MEDICAID 0181943 RR MEDICARE

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