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NPI Code Detail

MEDICARE: SICKLERVILLE INTERNAL MEDICINE ASSOCIATES INC

MEDICARE: SICKLERVILLE INTERNAL MEDICINE ASSOCIATES INC
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
1207R00000XInternal Medicine PhysicianMA61324NJ

Other Identifiers

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

General Provider Information

NPI Number : 1912911207
Entity Type Code : Organization
Provider Name (Legal Business Name) : SICKLERVILLE INTERNAL MEDICINE ASSOCIATES INC
Provider Business Mailing Address
First Line : 485 WILLIAMSTOWN RD
Second Line :
City : SICKLERVILLE
State : NJ
Zip : 08081-1777
Country : US
Telephone Number : 856-237-8100
Fax Number : 856-237-8142
Provider Business Practice Location Address
First Line : 485 WILLIAMSTOWN RD
Second Line :
City : SICKLERVILLE
State : NJ
Zip : 08081-1777
Country : US
Telephone Number : 856-237-8100
Fax Number : 856-237-8142
Authorized Official
Title or Position : MANAGING PARTNER
Name : DR. MAYNARD HOLGADO
Credential : D.O.
Telephone Number : 856-237-8160
Provider Enumeration Date : 07/29/2006
Last Update Date : 04/29/2008

Similar Medicare Providers

1083694913 — MRS. ELAINE GAIL LANGE R.N, A.P.N.
Practice Location Address:
485 WILLIAMSTOWN RD
SICKLERVILLE, NJ
08081-1777
Practice Phone: 856-227-6575
Practice Fax: 856-237-8042
1679526396 — DR. MAYNARD HOLGADO MD
Practice Location Address:
485 WILLIAMSTOWN RD
SICKLERVILLE, NJ
08081-1777
Practice Phone: 856-227-6575
Practice Fax: 856-237-8042
1639116569 — DR. NICHOLAS G. PALLADINO MD
Practice Location Address:
485 WILLIAMSTOWN RD
SICKLERVILLE, NJ
08081-1777
Practice Phone: 856-227-6575
Practice Fax: 856-237-8042
1720008931 — TARA L. WYCHE-BULLOCK M.D.
Practice Location Address:
485 WILLIAMSTOWN RD
SICKLERVILLE, NJ
08081-1777
Practice Phone: 856-237-8100
Practice Fax: 856-237-8042
1982704474 — DR. DANIEL A D'AURIA MD
Practice Location Address:
485 WILLIAMSTOWN RD
SICKLERVILLE, NJ
08081-1777
Practice Phone: 856-237-8045
Practice Fax: 856-237-8042
1154483238 — SICKLERVILLE INTERNAL MEDICINE
Practice Location Address:
485 WILLIAMSTOWN RD
SICKLERVILLE, NJ
08081-1777
Practice Phone: 856-237-8100
Practice Fax: 856-237-8042

Directions to “SICKLERVILLE INTERNAL MEDICINE ASSOCIATES INC ” Practice Location

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