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General NPI Number Information
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NPI Number | 1609807288
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Entity Type | Organization
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Legal Business Name | BECKETT FAMILY PRACTICE
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 03/18/2011
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Provider Practice Location Address
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Address Line | 545 BECKETT RD. SUITE 806
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City | LOGAN TWP.
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State | NJ
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Zip | 08085
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Country | US
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Telephone | 856-467-2556
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Fax | 856-467-3816
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Provider Business Mailing Address
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Address Line | 545 BECKETT RD. SUITE 806
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City | LOGAN TWP.
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State | NJ
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Zip | 08085
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Country | US
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Telephone | 856-467-2556
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Fax | 856-467-3816
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LOIS A LAGANELLA
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Credential |
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Telephone | 856-467-2556
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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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