Healthcare Provider Details

I. General information

NPI: 1275382897
Provider Name (Legal Business Name): DANIEL LIGA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2024
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BOWMAN DRIVE, LOWER LEVEL 2
VOORHEES NJ
08043
US

IV. Provider business mailing address

301 LIPPINCOTT DRIVE, SUITE 410
MARLTON NJ
08053
US

V. Phone/Fax

Practice location:
  • Phone: 856-247-3802
  • Fax:
Mailing address:
  • Phone: 856-355-0340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberF02241222
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR15966200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: