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General NPI Number Information
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NPI Number | 1407803596
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL SERVICE FUND OF DEBORAH HEART & LUNG CENTER
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 200 TRENTON RD
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City | BROWNS MILLS
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State | NJ
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Zip | 08015-1705
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Country | US
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Telephone | 609-893-1200
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Fax | 609-735-0175
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Provider Business Mailing Address
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Address Line | 200 TRENTON RD
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City | BROWNS MILLS
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State | NJ
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Zip | 08015-1705
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Country | US
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Telephone | 609-893-1200
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Fax | 609-735-0175
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. JOSEPH CHIRICHELLA
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Credential |
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Telephone | 609-893-1200
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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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