MEDICARE: ROBERT R HACKFORD JR. MD

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	2080P0006X	Developmental - Behavioral Pediatrics Physician	25MA08111000	NJ

General Provider Information

NPI Number	:	1790786689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT R HACKFORD JR. MD

Provider Business Mailing Address
First Line	:	211 S MAIN ST
Second Line	:	SUITE 301
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-2264
Country	:	US
Telephone Number	:	609-463-1577
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 S MAIN ST
Second Line	:	SUITE 301
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-2264
Country	:	US
Telephone Number	:	609-463-1577
Fax Number	:

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	06/17/2008

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