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General NPI Number Information
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NPI Number | 1922177856
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Entity Type | Organization
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Legal Business Name | INSPIRA HEALTH NETWORK MEDICAL GROUP, P.C.
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 1120 DELSEA DR N
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City | GLASSBORO
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State | NJ
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Zip | 08028-1444
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Country | US
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Telephone | 856-507-2783
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Fax | 856-205-0145
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Provider Business Mailing Address
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Address Line | 1120 DELSEA DR N
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City | GLASSBORO
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State | NJ
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Zip | 08028-1444
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Country | US
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Telephone | 856-507-2783
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Fax | 856-205-0145
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Authorized Official
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Title or Position | DIRECTOR REVENUE CYCLE
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Name | JAMES THOMAS O'CONNELL
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Credential |
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Telephone | 856-575-4777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State | NJ
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