Provider Demographics
NPI:1154542843
Name:HACKNEY, JANEL ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:JANEL
Middle Name:ELIZABETH
Last Name:HACKNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 SOUTH BROAD STREET
Mailing Address - Street 2:SUITE 360
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146
Mailing Address - Country:US
Mailing Address - Phone:215-685-6769
Mailing Address - Fax:215-685-6732
Practice Address - Street 1:4400 HAVERFORD AVENUE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-685-7601
Practice Address - Fax:215-685-7379
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD423961207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine