Provider Demographics
NPI:1457867277
Name:PINKNEY, NOVELETTE
Entity Type:Individual
Prefix:
First Name:NOVELETTE
Middle Name:
Last Name:PINKNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 38084
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-0084
Mailing Address - Country:US
Mailing Address - Phone:215-808-8344
Mailing Address - Fax:
Practice Address - Street 1:2300 W ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-1422
Practice Address - Country:US
Practice Address - Phone:215-225-2649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health