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General NPI Number Information
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NPI Number | 1518678804
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Entity Type | Organization
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Legal Business Name | ACTON HEALTHCARE LLC
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Dates
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Enumeration Date | 12/08/2022
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Last Update Date | 12/08/2022
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Provider Practice Location Address
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Address Line | 545 TILTON RD
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1217
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Country | US
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Telephone | 609-956-7105
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Fax | 609-241-8765
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Provider Business Mailing Address
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Address Line | 545 TILTON RD
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1217
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Country | US
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Telephone | 609-956-7105
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Fax | 609-241-8765
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Authorized Official
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Title or Position | CEO
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Name | DR. JON M REGIS
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Credential | MD
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Telephone | 609-226-1108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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