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General NPI Number Information
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NPI Number | 1518039056
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Entity Type | Organization
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Legal Business Name | INSPIRA MEDICAL CENTER WOODBURY INC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 01/06/2014
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Provider Practice Location Address
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Address Line | 75 W RED BANK AVE
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City | WOODBURY
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State | NJ
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Zip | 08096-1694
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Country | US
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Telephone | 856-853-2055
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Fax | 856-848-2879
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Provider Business Mailing Address
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Address Line | 75 W RED BANK AVE
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City | WOODBURY
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State | NJ
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Zip | 08096-1694
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Country | US
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Telephone | 856-853-2055
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Fax | 856-848-2879
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Authorized Official
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Title or Position | MANAGER
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Name | LINDA A VIERECK
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Credential |
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Telephone | 856-853-2168
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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 |
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License Number State |
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