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General NPI Number Information
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NPI Number | 1770382301
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Entity Type | Organization
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Legal Business Name | ENCORE WOUND CARE - AL LLC
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 731 BAY AVE
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City | SOMERS POINT
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State | NJ
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Zip | 08244-2378
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Country | US
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Telephone | 440-652-8748
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Fax | 440-582-3171
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Provider Business Mailing Address
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Address Line | 731 BAY AVE
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City | SOMERS POINT
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State | NJ
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Zip | 08244-2378
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Country | US
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Telephone | 440-652-8748
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Fax | 440-582-3171
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Authorized Official
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Title or Position | EVP OPERATIONS
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Name | MATTHEW LEGOWSKI
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Credential |
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Telephone | 609-703-5097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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