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NPI Code Detail

MEDICARE: ADAM KAGANOVICH

MEDICARE: ADAM KAGANOVICH
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
1183500000XPharmacist28RI04031500NJ

General Provider Information

NPI Number : 1518568401
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM KAGANOVICH
Provider Business Mailing Address
First Line : 111 S 11TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19107-4870
Country : US
Telephone Number : 856-235-7126
Fax Number :
Provider Business Practice Location Address
First Line : 3110 ROUTE 38
Second Line :
City : MOUNT LAUREL
State : NJ
Zip : 08054-9724
Country : US
Telephone Number : 856-235-7126
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2020
Last Update Date : 02/17/2025

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Directions to “ ADAM KAGANOVICH ” Practice Location

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