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General NPI Number Information
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NPI Number | 1114327830
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Entity Type | Organization
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Legal Business Name | GT URGENT CARE PC
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Dates
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Enumeration Date | 08/29/2014
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Last Update Date | 08/29/2014
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Provider Practice Location Address
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Address Line | 2001 COLLEGE DR STE 11
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City | CLEMENTON
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State | NJ
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Zip | 08021-5617
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Country | US
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Telephone | 856-566-3333
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 COLLEGE DR STE 11
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City | CLEMENTON
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State | NJ
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Zip | 08021-5617
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Country | US
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Telephone | 856-566-3333
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | JULIUS A MINGRONI
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Credential | D.O.
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Telephone | 856-566-3333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | NJ
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