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General NPI Number Information
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NPI Number | 1285688747
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Entity Type | Individual
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Provider Name | THEODORE DAVID CONLIFFE JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 06/10/2024
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Provider Practice Location Address
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Address Line | 999 ROUTE 73 N STE 301&401
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City | MARLTON
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State | NJ
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Zip | 08053-1227
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Country | US
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Telephone | 800-321-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 833 CHESTNUT ST STE 520
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4430
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Country | US
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Telephone | 609-677-7003
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Fax | 267-339-3761
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD065466L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 307356
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME152938
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 25MA07355800
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License Number State | NJ
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