Healthcare Provider Details

I. General information

NPI: 1215965231
Provider Name (Legal Business Name): EMERGENCY PHYSICIAN ASSOCIATES OF SOUTH JERSEY P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 05/27/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CARNIE BLVD
VOORHEES NJ
08043-1548
US

IV. Provider business mailing address

307 S EVERGREEN AVE
WOODBURY NJ
08096-2739
US

V. Phone/Fax

Practice location:
  • Phone: 856-686-4300
  • Fax:
Mailing address:
  • Phone: 856-686-4316
  • Fax: 865-291-3254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID ISTVAN
Title or Position: PRESIDENT
Credential: MD
Phone: 856-686-4300