Healthcare Provider Details

I. General information

NPI: 1467752600
Provider Name (Legal Business Name): VOORHEES NEUROLOGY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2010
Last Update Date: 10/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 COOPER ROAD SUITE 300
VOORHEES NJ
08043
US

IV. Provider business mailing address

93 COOPER ROAD SUITE 300
VOORHEES NJ
08043
US

V. Phone/Fax

Practice location:
  • Phone: 856-767-2670
  • Fax: 856-767-2590
Mailing address:
  • Phone: 856-767-2670
  • Fax: 856-767-2590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name: WILLIAM R. WOLFE
Title or Position: OWNER
Credential: MD
Phone: 856-767-2670