Healthcare Provider Details

I. General information

NPI: 1821060005
Provider Name (Legal Business Name): DEBRA M EPSTEIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 09/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S LENOLA RD BLDG. 2, SUITE 103
MAPLE SHADE NJ
08052-1630
US

IV. Provider business mailing address

PO BOX 344
MOORESTOWN NJ
08057-0344
US

V. Phone/Fax

Practice location:
  • Phone: 856-234-4436
  • Fax: 856-234-4469
Mailing address:
  • Phone: 856-234-4436
  • Fax: 856-234-4469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMA057497
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: