Provider Demographics
NPI:1740519487
Name:MCNALLY, LAURYN ANNE (DO)
Entity type:Individual
Prefix:DR
First Name:LAURYN
Middle Name:ANNE
Last Name:MCNALLY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:600 JESSUP RD
Mailing Address - Street 2:
Mailing Address - City:WEST DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08066-2413
Mailing Address - Country:US
Mailing Address - Phone:856-845-4061
Mailing Address - Fax:856-384-1770
Practice Address - Street 1:600 JESSUP RD
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08066-2413
Practice Address - Country:US
Practice Address - Phone:856-845-4061
Practice Address - Fax:856-384-1770
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A11020207V00000X
NJ25MB09283700207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology