Healthcare Provider Details
I. General information
NPI: 1770899163
Provider Name (Legal Business Name): MICHELLE CIFONE BILBAO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/24/2010
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 BOWMAN DR STE E315
VOORHEES NJ
08043-9637
US
IV. Provider business mailing address
200 BOWMAN DR STE E315
VOORHEES NJ
08043-9637
US
V. Phone/Fax
- Phone: 856-247-7310
- Fax: 856-247-7309
- Phone: 856-247-7310
- Fax: 856-247-7309
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 0102202881 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 65978-21 |
| License Number State | WI |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 25MB10392700 |
| License Number State | NJ |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | 25MB10397200 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: