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NPI Code Detail

MEDICARE: JEFFERSON HEALTH NEW JERSEY DIRECT PRIMARY CARE, P.C.

MEDICARE: JEFFERSON HEALTH NEW JERSEY DIRECT PRIMARY CARE, P.C.
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1740848530
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEFFERSON HEALTH NEW JERSEY DIRECT PRIMARY CARE, P.C.
Provider Business Mailing Address
First Line : 308 N HADDON AVE STE 308-1
Second Line :
City : HADDONFIELD
State : NJ
Zip : 08033-1723
Country : US
Telephone Number : 856-883-5249
Fax Number : 856-477-2539
Provider Business Practice Location Address
First Line : 308 N HADDON AVE STE 308-1
Second Line :
City : HADDONFIELD
State : NJ
Zip : 08033-1723
Country : US
Telephone Number : 856-883-5249
Fax Number : 856-477-2539
Authorized Official
Title or Position : MANAGING PHYSICIAN
Name : DR. JOSEPH JAMES RUNFOLA
Credential : MD
Telephone Number : 856-883-5249
Provider Enumeration Date : 06/05/2019
Last Update Date : 06/05/2019

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Directions to “JEFFERSON HEALTH NEW JERSEY DIRECT PRIMARY CARE, P.C. ” Practice Location

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