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General NPI Number Information
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NPI Number | 1689613648
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Entity Type | Organization
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Legal Business Name | CENTER FOR KIDNEY DISEASE AND HYPERTENSION, LLC
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 05/09/2013
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Provider Practice Location Address
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Address Line | 129 JOHNSON RD SUITE 4
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-1777
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Country | US
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Telephone | 856-374-4440
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Fax |
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Provider Business Mailing Address
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Address Line | 129 JOHNSON RD SUITE 4
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-1777
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Country | US
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Telephone | 856-374-4440
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Fax |
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Authorized Official
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Title or Position | PHYSICAN
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Name | VIRGINIA ANN IRWIN-OBREGON
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Credential | DO FACOI
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Telephone | 856-374-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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