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General NPI Number Information
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NPI Number | 1659393585
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Entity Type | Organization
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Legal Business Name | FREDERICK W. HEGGAN, D.O. P.A.
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 07/18/2008
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Provider Practice Location Address
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Address Line | 3320 SIMPSON AVE TRADERS LANE
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City | OCEAN CITY
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State | NJ
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Zip | 08226-2044
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Country | US
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Telephone | 609-814-9550
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Fax | 609-814-9544
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Provider Business Mailing Address
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Address Line | 3320 SIMPSON AVE TRADERS LANE
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City | OCEAN CITY
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State | NJ
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Zip | 08226-2044
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Country | US
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Telephone | 609-814-9550
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Fax | 609-814-9544
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Authorized Official
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Title or Position | OWNER
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Name | FREDERICK W. HEGGAN
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Credential | D.O.
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Telephone | 609-814-9550
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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 | 25MB02587100
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License Number State | NJ
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