Healthcare Provider Details

I. General information

NPI: 1922822865
Provider Name (Legal Business Name): DR. COREY BRYTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date: 01/08/2025
Reactivation Date: 04/10/2026

III. Provider practice location address

1 COOPER PLZ
CAMDEN NJ
08103-1461
US

IV. Provider business mailing address

ONE COOPER PLAZA
CAMDEN NJ
08103
US

V. Phone/Fax

Practice location:
  • Phone: 856-342-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: