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General NPI Number Information
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NPI Number | 1497938260
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Entity Type | Organization
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Legal Business Name | ZACH BROYER MD LLC
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Dates
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Enumeration Date | 12/14/2007
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Last Update Date | 12/14/2007
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Provider Practice Location Address
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Address Line | 123 EGG HARBOR RD STE 200
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City | SEWELL
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State | NJ
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Zip | 08080-9406
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Country | US
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Telephone | 484-452-8003
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Fax |
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Provider Business Mailing Address
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Address Line | 8383 BURLINGTON RD
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City | MURRAY
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State | NJ
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Zip | 07974
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Country | US
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Telephone | 484-452-8003
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. BERNADETTE N SCARDUZIO
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Credential |
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Telephone | 484-452-8003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 25MA08027500
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License Number State | NJ
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