Healthcare Provider Details

I. General information

NPI: 1235672866
Provider Name (Legal Business Name): SPECIALTY CARE AT WASHINGTON TOWNSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2016
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 FRIES MILL RD BUILDING J
TURNERSVILLE NJ
08012-2015
US

IV. Provider business mailing address

188 FRIES MILL RD SUITE N-3
TURNERSVILLE NJ
08012-2015
US

V. Phone/Fax

Practice location:
  • Phone: 856-740-2300
  • Fax: 856-629-1896
Mailing address:
  • Phone: 856-875-8000
  • Fax: 856-629-1460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT VENUTI
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 856-875-8000