Provider Demographics
NPI:1124036496
Name:MCDONNELL, ELIZABETH LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:LYNN
Last Name:MCDONNELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CAPITAL WAY
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2520
Mailing Address - Country:US
Mailing Address - Phone:800-637-2374
Mailing Address - Fax:
Practice Address - Street 1:1 CAPITAL WAY
Practice Address - Street 2:CAPITAL HEALTH MEDICAL CENTER - HOPEWELL
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534
Practice Address - Country:US
Practice Address - Phone:800-637-2374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01042700A207V00000X
PAMD446044207V00000X, 207V00000X
NJ25MA09208100207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILUPIN# H77399Medicare UPIN