Organization Name: | SOUTHERN JERSEY FAMILY MEDICAL CENTERS, INC, |
NPI Number: | 1164800017 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMINATA HOWARD (CREDENTIALING COORDINATOR) |
Mailing Address: | 1125 Atlantic Ave Atlantic City |
State: | NJ US |
Postal Code: | 084014806 |
Phone Number: | 6093480066 |
Fax Number: | 6093481157 |
NPI Enumeration Date: | 05/12/2015 |
NPI Last Update Date: | 05/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LX0001X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Obstetrics & Gynecology |
Taxonomy Definition: |