Provider Demographics
NPI:1346258985
Name:CUNNANE, MARY F (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:F
Last Name:CUNNANE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:615 CHESTNUT ST
Mailing Address - Street 2:14TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-4404
Mailing Address - Country:US
Mailing Address - Phone:215-955-9655
Mailing Address - Fax:215-955-2420
Practice Address - Street 1:1020 LOCUST ST
Practice Address - Street 2:SUITE 521
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6731
Practice Address - Country:US
Practice Address - Phone:215-503-7822
Practice Address - Fax:215-503-4817
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-11-13
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Provider Licenses
StateLicense IDTaxonomies
PAMD009345E207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8031908Medicaid
PA00954065Medicaid
PA00954065Medicaid