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General NPI Number Information
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NPI Number | 1598443517
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Entity Type | Organization
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Legal Business Name | SHORE ATLANTIC MEDICINE LLC
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Dates
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Enumeration Date | 07/10/2023
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 1740 BAYSHORE RD
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City | VILLAS
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State | NJ
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Zip | 08251-2142
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Country | US
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Telephone | 609-886-4441
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Fax | 609-889-1766
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Provider Business Mailing Address
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Address Line | 1740 BAYSHORE RD
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City | VILLAS
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State | NJ
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Zip | 08251-2142
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Country | US
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Telephone | 609-886-4441
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Fax | 609-889-1766
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Authorized Official
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Title or Position | CEO
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Name | DR. ALOYSIUS C ONWUKA
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Credential | MD
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Telephone | 609-886-4441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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