Healthcare Provider Details
I. General information
NPI: 1689653644
Provider Name (Legal Business Name): JOSEPH B SZGALSKY MD, FAAFP
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/10/2006
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 ROWAN BLVD
GLASSBORO NJ
08028-2260
US
IV. Provider business mailing address
200 ROWAN BLVD
GLASSBORO NJ
08028-2260
US
V. Phone/Fax
- Phone: 856-582-0500
- Fax: 856-582-0163
- Phone: 856-582-0500
- Fax: 856-582-0163
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MA48442 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: