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NPI Code Detail

MEDICARE: DR. TERRENCE GLENDON ISHMAEL MB.BB

MEDICARE: DR. TERRENCE GLENDON ISHMAEL MB.BB
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
1207X00000XOrthopaedic Surgery Physician25MA10884600NJ
2207X00000XOrthopaedic Surgery PhysicianMD468019PA

General Provider Information

NPI Number : 1952698896
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERRENCE GLENDON ISHMAEL MB.BB
Provider Business Mailing Address
First Line : 1 FEDERAL ST STE 200
Second Line :
City : CAMDEN
State : NJ
Zip : 08103-1088
Country : US
Telephone Number : 848-288-6935
Fax Number :
Provider Business Practice Location Address
First Line : 1 COOPER PLZ
Second Line :
City : CAMDEN
State : NJ
Zip : 08103-1461
Country : US
Telephone Number : 856-342-3159
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2011
Last Update Date : 06/05/2026

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