MEDICARE: DONNA JOYCE LOUGHLIN-PHERRIBO D.O.

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	207Q00000X	Family Medicine Physician	MB07418200	NJ
2	207Q00000X	Family Medicine Physician	OS008092L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881650703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA JOYCE LOUGHLIN-PHERRIBO D.O.

Provider Business Mailing Address
First Line	:	120 S WHITE HORSE PIKE
Second Line	:
City	:	HAMMONTON
State	:	NJ
Zip	:	08037-1804
Country	:	US
Telephone Number	:	609-561-4211
Fax Number	:	609-561-1536

Provider Business Practice Location Address
First Line	:	120 S WHITE HORSE PIKE
Second Line	:
City	:	HAMMONTON
State	:	NJ
Zip	:	08037-1804
Country	:	US
Telephone Number	:	609-561-4211
Fax Number	:	609-561-1536

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

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	02/03/2011

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