Healthcare Provider Details

I. General information

NPI: 1730340167
Provider Name (Legal Business Name): MARY ANN MACATOL KUMAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 ROUTE 70 E STE A
CHERRY HILL NJ
08034-2408
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-375-6240
  • Fax: 856-375-6241
Mailing address:
  • Phone: 856-375-6240
  • Fax: 856-375-6241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCI-0009221
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD438129
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA08638200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: