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General NPI Number Information
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NPI Number | 1528108917
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Entity Type | Organization
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Legal Business Name | BUENA FAMILY PRACTICE CENTER LLC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 1315 HARDING HWY
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City | RICHLAND
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State | NJ
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Zip | 08350-0310
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Country | US
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Telephone | 856-697-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 1315 HARDING HIGHWAY PO BOX 310
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City | RICHLAND
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State | NJ
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Zip | 08350
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Country | US
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Telephone | 856-697-0300
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | JOHN A PIROLLI
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Credential |
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Telephone | 856-697-0300
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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 | MB64919
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MB38680
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MB40881
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License Number State | NJ
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