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General NPI Number Information
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NPI Number | 1861590978
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Entity Type | Organization
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Legal Business Name | MEETINGHOUSE FAMILY PHYSICIANS PA
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/28/2024
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Provider Practice Location Address
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Address Line | 105 EVESBORO MEDFORD RD STE I
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City | MARLTON
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State | NJ
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Zip | 08053-3865
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Country | US
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Telephone | 856-596-9050
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Fax | 856-596-0320
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Provider Business Mailing Address
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Address Line | 105 EVESBORO MEDFORD RD STE I
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City | MARLTON
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State | NJ
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Zip | 08053-3865
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Country | US
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Telephone | 856-596-9050
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Fax | 856-596-0320
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | PAULA TONZELLO
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Credential |
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Telephone | 856-596-9050
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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 | MA0368900
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License Number State | NJ
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