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General NPI Number Information
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NPI Number | 1164432407
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Entity Type | Organization
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Legal Business Name | DORFNER FAMILY MEDICINE LLC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 811 SUNSET RD SUITE 101
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City | BURLINGTON
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State | NJ
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Zip | 08016-3645
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Country | US
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Telephone | 609-387-9242
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Fax | 609-387-9408
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Provider Business Mailing Address
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Address Line | 811 SUNSET RD SUITE 101
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City | BURLINGTON
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State | NJ
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Zip | 08016-3645
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Country | US
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Telephone | 609-387-9242
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Fax | 609-387-9408
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOYCE NICOLO
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Credential |
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Telephone | 609-387-9242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MB53910
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License Number State | NJ
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