Healthcare Provider Details

I. General information

NPI: 1053425686
Provider Name (Legal Business Name): CENTERTON FAMILY PRACTICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

798 CENTERTON ROAD
ELMER NJ
08318-0890
US

IV. Provider business mailing address

PO BOX 890
ELMER NJ
08318-0890
US

V. Phone/Fax

Practice location:
  • Phone: 856-358-6161
  • Fax: 856-358-0142
Mailing address:
  • Phone: 856-358-6161
  • Fax: 856-358-0142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER R ALTAMURO
Title or Position: PHYSICIAN/OWNER
Credential: D.O.
Phone: 856-358-6161