Healthcare Provider Details

I. General information

NPI: 1780631648
Provider Name (Legal Business Name): MACAIONE & PAPA DERMATOLOGY ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 WHITE HORSE RD SUITE C103
VOORHEES NJ
08043-2461
US

IV. Provider business mailing address

707 WHITE HORSE RD SUITE C103
VOORHEES NJ
08043-2461
US

V. Phone/Fax

Practice location:
  • Phone: 856-627-1900
  • Fax: 856-627-6907
Mailing address:
  • Phone: 856-627-1900
  • Fax: 856-627-6907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMB70671
License Number StateNJ

VIII. Authorized Official

Name: CHRISTINE A PAPA
Title or Position: PRESIDENT
Credential: DO
Phone: 856-627-1900