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NPI Code Detail

MEDICARE: MOBILE WOUND CONSULTANTS

MEDICARE: MOBILE WOUND CONSULTANTS
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
1208600000XSurgery Physician

General Provider Information

NPI Number : 1477628485
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOBILE WOUND CONSULTANTS
Provider Business Mailing Address
First Line : 127 N BROAD ST
Second Line :
City : WOODBURY
State : NJ
Zip : 08096-1718
Country : US
Telephone Number : 856-845-0500
Fax Number : 856-384-8757
Provider Business Practice Location Address
First Line : 1900 S BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19145-2304
Country : US
Telephone Number : 856-845-0500
Fax Number : 856-384-8757
Authorized Official
Title or Position : PARTNER
Name : THERESA BRADY
Credential : CRNP
Telephone Number : 856-845-0500
Provider Enumeration Date : 11/22/2006
Last Update Date : 08/22/2020

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Directions to “MOBILE WOUND CONSULTANTS ” Practice Location

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