Healthcare Provider Details
I. General information
NPI: 1134173834
Provider Name (Legal Business Name): CHILDREN AND ADOLESCENT RAPID EMERGENCY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2006
Last Update Date: 03/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 CARNIE BLVD CARES
VOORHEES NJ
08043-1548
US
IV. Provider business mailing address
402 LIPPINCOTT DR
MARLTON NJ
08053-4112
US
V. Phone/Fax
- Phone: 856-782-3300
- Fax: 856-504-8029
- Phone: 856-782-3300
- Fax: 856-504-8029
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0204X |
| Taxonomy | Pediatric Emergency Medicine (Pediatrics) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
M
TEDESCHI
Title or Position: PRESIDENT
Credential: MD
Phone: 856-782-3300