Individual ProviderMaria MckennaPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3400 Spruce St, 4 Silverstein, Philadelphia, PA 19104-4238(215) 662-4000PECOS EnrollmentBased on the most recent information from CMS, provider Maria Mckenna is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1073929212Provider TypeIndividualFull NameMckenna, MariaGenderFemaleSole ProprietorNoEnumeration Date7/9/2014Last Updated7/9/2014Contact InformationPractice LocationPractice Address3400 Spruce St, 4 Silverstein, Philadelphia, PA 19104-4238Phone(215) 662-4000FaxUnlisted FaxMailing LocationMailing Address3400 Spruce St, 4 Silverstein, Philadelphia, PA 19104-4238Phone(215) 662-4000FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363AM0700XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseMA056889Pennsylvania