MEDICARE: SERKAN ERCAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	37AC00680900	NJ

General Provider Information

NPI Number	:	1568189116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERKAN ERCAN

Provider Business Mailing Address
First Line	:	900 KINGS HWY N STE 204
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034-1516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 KINGS HWY N STE 204
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034-1516
Country	:	US
Telephone Number	:	856-208-7300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2022
Last Update Date	:	10/25/2022

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Directions to “ SERKAN ERCAN ” Practice Location

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