=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124329560
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JODI ABRAMOWITZ D.O., P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/16/2010
-----------------------------------------------------
Last Update Date | 11/16/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 210 NEW RD SUITE 11
-----------------------------------------------------
City | LINWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08221-1371
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-927-6100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 210 NEW RD SUITE 11
-----------------------------------------------------
City | LINWOOD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08221-1371
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-927-6100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JODI SUSAN ABRAMOWITZ
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 609-927-6100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | MB04276900
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------