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General NPI Number Information
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NPI Number | 1164697538
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Entity Type | Individual
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Provider Name | JULIE SYGENDA- MCCORMICK PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 2906 ROUTE 130
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City | DELRAN
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State | NJ
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Zip | 08075-2521
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Country | US
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Telephone | 856-769-4411
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Fax | 856-764-4116
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Provider Business Mailing Address
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Address Line | 2906 ROUTE 130
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City | DELRAN
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State | NJ
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Zip | 08075-2521
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Country | US
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Telephone | 856-764-4115
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Fax | 856-764-4116
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MP00100600
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License Number State | NJ
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