Healthcare Provider Details

I. General information

NPI: 1790803351
Provider Name (Legal Business Name): NEW JERSEY ONCOLOGY SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 09/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 MEDICAL CENTER DR
SEWELL NJ
08080-2358
US

IV. Provider business mailing address

2234 COLONIAL BLVD
FORT MYERS FL
33907-1412
US

V. Phone/Fax

Practice location:
  • Phone: 856-583-3008
  • Fax: 856-582-3009
Mailing address:
  • Phone: 239-931-7342
  • Fax: 239-931-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL J. KATIN
Title or Position: PRESIDENT
Credential: MD
Phone: 239-931-7277