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General NPI Number Information
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NPI Number | 1215965231
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Entity Type | Organization
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Legal Business Name | EMERGENCY PHYSICIAN ASSOCIATES OF SOUTH JERSEY P C
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 05/27/2022
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Provider Practice Location Address
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Address Line | 101 CARNIE BLVD
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City | VOORHEES
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State | NJ
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Zip | 08043-1548
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Country | US
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Telephone | 856-686-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 307 S EVERGREEN AVE
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City | WOODBURY
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State | NJ
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Zip | 08096-2739
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Country | US
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Telephone | 856-686-4316
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Fax | 865-291-3254
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID ISTVAN
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Credential | MD
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Telephone | 856-686-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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