Healthcare Provider Details

I. General information

NPI: 1063477909
Provider Name (Legal Business Name): ATLANTIC RHEUMATOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 N MAIN ST UNIT B3
PLEASANTVILLE NJ
08232
US

IV. Provider business mailing address

PO BOX 723
BRIDGETON NJ
08302
US

V. Phone/Fax

Practice location:
  • Phone: 609-645-3200
  • Fax: 609-645-3144
Mailing address:
  • Phone: 609-645-3200
  • Fax: 609-645-3144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANA M CILURSU
Title or Position: PRESIDENT
Credential: MD
Phone: 609-645-3200