Healthcare Provider Details

I. General information

NPI: 1447272927
Provider Name (Legal Business Name): JOSEPH L MACCARONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BOWMAN DR SUITE E325
VOORHEES NJ
08043-9623
US

IV. Provider business mailing address

7000 ATRIUM WAY SUITE 6
MOUNT LAUREL NJ
08054-3917
US

V. Phone/Fax

Practice location:
  • Phone: 856-247-7420
  • Fax: 856-247-7421
Mailing address:
  • Phone: 856-840-4500
  • Fax: 856-234-4241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number25MA05576800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: