NPI Code Detail JSON Logo

1770457491 NPI number — MARLTON PIKE EAST MEDICAL LLC

NPI Number: 1770457491
Health Care Provider/Practitioner: MARLTON PIKE EAST MEDICAL LLC

Information about “1770457491” NPI (MARLTON PIKE EAST MEDICAL LLC) exists in 1770457491 in HTML format HTML  |  1770457491 in plain Text format TXT  |  1770457491 in PDF (Portable Document Format) PDF  |  1770457491 in an XML format XML  formats.

NPI Number : 1770457491 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1770457491",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MARLTON PIKE EAST MEDICAL LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1930 MARLTON PIKE E STE F34",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHERRY HILL",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "08003-4103",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "856-348-3700",
    "MailingAddressFaxNumber": "856-348-3999",
    "FirstLinePracticeLocationAddress": "1930 MARLTON PIKE E STE F34",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHERRY HILL",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "08003-4103",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "856-348-3700",
    "PracticeLocationAddressFaxNumber": "856-348-3999",
    "EnumerationDate": "10/04/2025",
    "LastUpdateDate": "10/04/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SANTOS",
    "AuthorizedOfficialFirstName": "LUIS",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PHYSICIAN",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "856-348-3700",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QE0002X",
          "TaxonomyName": "Emergency Care Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QP3300X",
          "TaxonomyName": "Pain Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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