Healthcare Provider Details

I. General information

NPI: 1659335966
Provider Name (Legal Business Name): MARLOWE ZWILLENBERG & GHADERI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 04/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W SPROUL RD STE 220
SPRINGFIELD PA
19064-2033
US

IV. Provider business mailing address

175 W COHAWKIN RD STE C
CLARKSBORO NJ
08020-1145
US

V. Phone/Fax

Practice location:
  • Phone: 610-328-4800
  • Fax:
Mailing address:
  • Phone: 856-423-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: MAHMOUD GHADERI
Title or Position: MANAGING PARTNER
Credential: DO
Phone: 856-423-7700