Healthcare Provider Details

I. General information

NPI: 1679545214
Provider Name (Legal Business Name): ALFRED J. MOYER APN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 10/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 CHAPEL AVE W SUITE 100
CHERRY HILL NJ
08002-2051
US

IV. Provider business mailing address

2250 CHAPEL AVE W SUITE 100
CHERRY HILL NJ
08002-2051
US

V. Phone/Fax

Practice location:
  • Phone: 856-482-9000
  • Fax: 856-482-1159
Mailing address:
  • Phone: 856-482-9000
  • Fax: 856-482-1159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number26NC07309600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NC07309600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: