Healthcare Provider Details

I. General information

NPI: 1992747356
Provider Name (Legal Business Name): GEROPSYCH NURSING ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 11/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 COTSWOLD LN
CHERRY HILL NJ
08034-3017
US

IV. Provider business mailing address

PO BOX 1910
CHERRY HILL NJ
08034-0121
US

V. Phone/Fax

Practice location:
  • Phone: 609-417-4564
  • Fax: 856-428-9427
Mailing address:
  • Phone: 609-417-4564
  • Fax: 856-428-9427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. NANCY O'DOWD
Title or Position: MEMBER
Credential: APRN
Phone: 609-417-4564