Provider Demographics
NPI:1861032039
Name:DONNELLY, ANNALISA (DPM)
Entity Type:Individual
Prefix:MRS
First Name:ANNALISA
Middle Name:
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:ANNALISA
Other - Middle Name:
Other - Last Name:FIORITI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:1000 FLORAL VALE BLVD #400
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19067
Mailing Address - Country:US
Mailing Address - Phone:800-672-0676
Mailing Address - Fax:
Practice Address - Street 1:1000 FLORAL VALE BLVD #400
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:PA
Practice Address - Zip Code:19067
Practice Address - Country:US
Practice Address - Phone:800-672-0676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003613-L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist