Healthcare Provider Details

I. General information

NPI: 1881064442
Provider Name (Legal Business Name): BANCROFT A NEW JERSEY NONPROFIT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2015
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WHITE HORSE RD
VOORHEES NJ
08043-4406
US

IV. Provider business mailing address

1255 CALDWELL RD
CHERRY HILL NJ
08034-3220
US

V. Phone/Fax

Practice location:
  • Phone: 856-348-1137
  • Fax: 865-429-4755
Mailing address:
  • Phone: 856-429-0010
  • Fax: 865-429-4755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER CRIPPS
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 856-348-1196