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General NPI Number Information
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NPI Number | 1144211087
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Entity Type | Organization
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Legal Business Name | SOUTHERN ONCOLOGY HEMATOLOGY ASSOC
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 11/05/2015
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Provider Practice Location Address
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Address Line | 1505 W SHERMAN AVE SUITE 101
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City | VINELAND
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State | NJ
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Zip | 08360-6912
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Country | US
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Telephone | 856-696-9550
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Fax | 856-696-4932
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Provider Business Mailing Address
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Address Line | 1505 W. SHERMAN AVENUE SUITE 101
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City | VINELAND
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State | NJ
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Zip | 08360-5838
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Country | US
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Telephone | 856-696-9550
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Fax | 856-696-4932
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KUSH SACHDEVA
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Credential | MD
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Telephone | 856-696-9550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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