Healthcare Provider Details
I. General information
NPI: 1134225907
Provider Name (Legal Business Name): DENISE FARNATH-ALBER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/16/2006
Last Update Date: 03/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
48 N BROADWAY
PENNSVILLE NJ
08070-1754
US
IV. Provider business mailing address
48 N BROADWAY
PENNSVILLE NJ
08070-1754
US
V. Phone/Fax
- Phone: 856-678-4800
- Fax: 856-678-3630
- Phone: 856-678-4800
- Fax: 856-678-3630
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | 25MA06953000 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: