Healthcare Provider Details

I. General information

NPI: 1528156981
Provider Name (Legal Business Name): FREDERIC LEE GINSBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 BRACE RD SUITE 103
CHERRY HILL NJ
08034-3213
US

IV. Provider business mailing address

1 COOPER PLZ 3 DORRANCE
CAMDEN NJ
08103-1461
US

V. Phone/Fax

Practice location:
  • Phone: 856-938-2052
  • Fax: 856-429-1561
Mailing address:
  • Phone: 856-342-2604
  • Fax: 856-968-8282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMA40363
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: