Healthcare Provider Details

I. General information

NPI: 1548419286
Provider Name (Legal Business Name): ATLANTICARE PHYSICIAN GROUP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2008
Last Update Date: 09/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ENGLISH CREEK AVE SUITE 214
EGG HARBOR TOWNSHIP NJ
08234-5549
US

IV. Provider business mailing address

2500 ENGLISH CREEK AVE SUITE 214
EGG HARBOR TOWNSHIP NJ
08234-5549
US

V. Phone/Fax

Practice location:
  • Phone: 609-677-7211
  • Fax: 609-677-7210
Mailing address:
  • Phone: 609-677-7211
  • Fax: 609-677-7210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARILOUISE VENDITTI
Title or Position: PRESIDENT
Credential: MD
Phone: 609-441-8099