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General NPI Number Information
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NPI Number | 1386682094
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Entity Type | Organization
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Legal Business Name | CMC DEPT OF MEDICINE GROUP PA
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 3 COOPER PLAZA SUITE 215
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City | CAMDEN
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State | NJ
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Zip | 08103-1438
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Country | US
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Telephone | 856-342-2439
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Fax | 856-342-7832
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Provider Business Mailing Address
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Address Line | 1 FEDERAL STREET SW-200
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City | CAMDEN
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State | NJ
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Zip | 08103-1155
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Country | US
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Telephone | 856-356-4924
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Fax | 856-382-6455
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICE
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Name | ANTHONY J. MAZZARELLI
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Credential | M.D.
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Telephone | 856-968-7858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NJ
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