Healthcare Provider Details

I. General information

NPI: 1841375565
Provider Name (Legal Business Name): BENJAMIN D DIJOSEPH JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 JESSUP RD
PAULSBORO NJ
08066-2413
US

IV. Provider business mailing address

600 JESSUP RD
PAULSBORO NJ
08066-2413
US

V. Phone/Fax

Practice location:
  • Phone: 856-845-4061
  • Fax: 856-384-1770
Mailing address:
  • Phone: 856-845-4061
  • Fax: 856-384-1770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MB06276900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: