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General NPI Number Information
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NPI Number | 1902635915
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Entity Type | Individual
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Provider Name | BLONDINA KOVACEVIC NP
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Gender | Female
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Dates
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Enumeration Date | 07/29/2024
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 100 BOWMAN DR
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City | VOORHEES
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State | NJ
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Zip | 08043-9612
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Country | US
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Telephone | 856-355-7118
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Fax | 856-325-5222
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 410
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 856-355-7118
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Fax | 856-325-5222
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 406210
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ15126400
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License Number State | NJ
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