Provider Demographics
NPI:1083892533
Name:MC CONNELL, ALIA (MD, PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALIA
Middle Name:
Last Name:MC CONNELL
Suffix:
Gender:
Credentials:MD, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COOPER PLZ
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1461
Mailing Address - Country:US
Mailing Address - Phone:856-757-7767
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-757-7767
Practice Address - Fax:856-412-5363
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18185183500000X
IL051.292295183500000X
DCPH100000591183500000X
NJP23-00801207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No183500000XPharmacy Service ProvidersPharmacist