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General NPI Number Information
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NPI Number | 1336193416
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH CENTER
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Dates
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Enumeration Date | 05/21/2006
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 630 SALEM AVE
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City | WOODBURY
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State | NJ
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Zip | 08096-3118
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Country | US
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Telephone | 856-853-7577
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Fax | 856-845-7829
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Provider Business Mailing Address
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Address Line | 630 SALEM AVE
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City | WOODBURY
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State | NJ
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Zip | 08096-3118
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Country | US
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Telephone | 856-853-7577
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Fax | 856-845-7829
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Authorized Official
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Title or Position | PHYSICIAN
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Name | JAMES GAETA
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Credential | D.C.
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Telephone | 856-856-7577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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