Healthcare Provider Details

I. General information

NPI: 1184650848
Provider Name (Legal Business Name): ANNA ALBERICI D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 DELSEA DR N
GLASSBORO NJ
08028-1403
US

IV. Provider business mailing address

335 DELSEA DR N
GLASSBORO NJ
08028-1403
US

V. Phone/Fax

Practice location:
  • Phone: 856-451-4700
  • Fax: 856-451-0029
Mailing address:
  • Phone: 856-863-5720
  • Fax: 856-863-5730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMB05347600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: