Doctor Name: | ROBERT AUSTIN |
NPI Number: | 1497144430 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | APN |
License Number: | 26NR12388200 |
Business Practice Address: | 849 Cooper St Deptford, NJ - 080962571 |
Business Phone Number: | 8568486346 |
Business Fax Number: | 8568485734 |
Mailing Address: | 849 Cooper St, DEPTFORD |
State: | NJ |
Postal Code: | 080962571 |
Phone Number: | 8568486346 |
Fax Number: | 8568485734 |
NPI Enumeration Date: | 01/14/2015 |
NPI Last Update Date: | 02/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 26NR12388200 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |