Healthcare Provider Details

I. General information

NPI: 1215631049
Provider Name (Legal Business Name): ARIEL T. PAZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 LIPPINCOTT DR
MARLTON NJ
08053-4805
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-355-7144
  • Fax: 856-355-7143
Mailing address:
  • Phone: 856-355-7144
  • Fax: 856-355-7143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MB13125500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: