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General NPI Number Information
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NPI Number | 1760639074
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Entity Type | Individual
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Provider Name | JANICE CLARICIA LAMPAGO PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/19/2008
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 318 WHITE HORSE PIKE
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City | HADDON HEIGHTS
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State | NJ
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Zip | 08035-1705
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Country | US
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Telephone | 856-547-6000
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Fax | 856-546-3189
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Provider Business Mailing Address
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Address Line | PO BOX 3001
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City | VOORHEES
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State | NJ
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Zip | 08043-0598
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Country | US
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Telephone | 856-782-3300
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Fax | 856-762-1751
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP000313200
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License Number State | NJ
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