Healthcare Provider Details

I. General information

NPI: 1528674520
Provider Name (Legal Business Name): MRS. MARIA MARGARITA BAMBER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 09/17/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 CATHY LANE SUITE 103
FLORENCE NJ
08518
US

IV. Provider business mailing address

6 MANORHOUSE DR
EWING NJ
08638-1728
US

V. Phone/Fax

Practice location:
  • Phone: 609-499-0165
  • Fax:
Mailing address:
  • Phone: 609-472-2014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00539800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: