MEDICARE: DR. OFELIA RAMOSO MANGUBAT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MA34367	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073515763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OFELIA RAMOSO MANGUBAT M.D.

Provider Business Mailing Address
First Line	:	2301 E EVESHAM RD
Second Line	:	THE PAVILIONS OF VOORHEES, STE 405
City	:	VOORHEES
State	:	NJ
Zip	:	08043-4501
Country	:	US
Telephone Number	:	856-772-4988
Fax Number	:	856-772-2514

Provider Business Practice Location Address
First Line	:	2301 E EVESHAM RD
Second Line	:	THE PAVILIONS OF VOORHEES, STE 405
City	:	VOORHEES
State	:	NJ
Zip	:	08043-4501
Country	:	US
Telephone Number	:	856-772-4988
Fax Number	:	856-772-2514

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	07/08/2007

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