Healthcare Provider Details

I. General information

NPI: 1306871314
Provider Name (Legal Business Name): SOUTH JERSEY HEALTH SYSTEM EMERGENCY PHYSICIAN SERVICES P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 03/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 FRONT ST
ELMER NJ
08318-2101
US

IV. Provider business mailing address

307 S EVERGREEN AVE
WOODBURY NJ
08096-2739
US

V. Phone/Fax

Practice location:
  • Phone: 856-363-1000
  • Fax: 856-358-2528
Mailing address:
  • Phone: 856-686-4316
  • Fax: 865-291-3254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM DI CINDIO
Title or Position: ER DEPT DIRECTOR
Credential: DO
Phone: 856-969-1000