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General NPI Number Information
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NPI Number | 1386601649
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Entity Type | Individual
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Provider Name | TARA A VOGDES DO
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Gender | Female
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 336 96TH ST STE 1
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City | STONE HARBOR
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State | NJ
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Zip | 08247-1439
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Country | US
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Telephone | 609-967-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FEDERAL ST STE 200
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City | CAMDEN
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State | NJ
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Zip | 08103-1088
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Country | US
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Telephone | 848-288-6935
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Fax | 732-790-0107
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB07211700
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License Number State | NJ
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