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NPI 1174031603

NPI 1174031603 : ROBIN JEFFERSON : PISCATAWAY, NJ

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General NPI Number Information
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    NPI Number           |    1174031603
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    Entity Type          |    Individual 
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    Provider Name        |    ROBIN JEFFERSON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/18/2018
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    Last Update Date     |    01/18/2018
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Provider Practice Location Address
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    Address Line         |    671 HOES LN W 
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    City                 |    PISCATAWAY
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    State                |    NJ
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    Zip                  |    08854-8021
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    Country              |    US
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    Telephone            |    856-566-6200
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1220 EMPIRE AVE 
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    City                 |    CAMDEN
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    State                |    NJ
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    Zip                  |    08103-2812
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    Country              |    US
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    Telephone            |    856-993-3032
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    Fax                  |    
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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        |    171M00000X
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    Taxonomy Name        |    Case Manager/Care Coordinator
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    License Number       |    
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    License Number State |    
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