Provider Demographics
NPI:1770774564
Name:SCHECKENBACH, MARY ELLEN (M AC)
Entity type:Individual
Prefix:MS
First Name:MARY ELLEN
Middle Name:
Last Name:SCHECKENBACH
Suffix:
Gender:F
Credentials:M AC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3901B MAIN ST
Mailing Address - Street 2:201
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19127-2191
Mailing Address - Country:US
Mailing Address - Phone:215-508-2300
Mailing Address - Fax:215-509-7430
Practice Address - Street 1:3901B MAIN ST
Practice Address - Street 2:201
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19127-2191
Practice Address - Country:US
Practice Address - Phone:215-508-2300
Practice Address - Fax:215-509-7430
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAAK000123L171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist