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General NPI Number Information
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NPI Number | 1073507166
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Entity Type | Organization
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Legal Business Name | SOUTH JERSEY HEART GROUP
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 539 EGG HARBOR RD
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City | SEWELL
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State | NJ
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Zip | 08080-2371
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Country | US
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Telephone | 856-589-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 9 ARBOUR LN
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City | SEWELL
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State | NJ
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Zip | 08080-3710
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Country | US
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Telephone | 856-371-9928
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Fax |
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Authorized Official
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Title or Position | CARDIOLOGY NURSE PRACTITIONER
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Name | MS. NELENE M MILLIGAN
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Credential | NP
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Telephone | 856-589-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 26NJ00033300
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License Number State | NJ
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