Healthcare Provider Details

I. General information

NPI: 1255576682
Provider Name (Legal Business Name): RAYMOND TWUM-BARIMA APN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2008
Last Update Date: 04/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 HIGH ST FL 2A
MOUNT HOLLY NJ
08060-1476
US

IV. Provider business mailing address

137 HIGH ST FL 2A
MOUNT HOLLY NJ
08060-1476
US

V. Phone/Fax

Practice location:
  • Phone: 609-474-0120
  • Fax:
Mailing address:
  • Phone: 609-474-0120
  • Fax: 609-474-0121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00806700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: