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NPI Code Detail

MEDICARE: BRIAN J PAHLOW D.O.

MEDICARE: BRIAN J PAHLOW D.O.
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
1207RC0000XCardiovascular Disease Physician25MB04797500NJ
2207RC0000XCardiovascular Disease PhysicianC2-0005949DE

General Provider Information

NPI Number : 1972693349
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN J PAHLOW D.O.
Provider Business Mailing Address
First Line : 125 EAST AVE
Second Line : SUITE D
City : WOODSTOWN
State : NJ
Zip : 08098-1351
Country : US
Telephone Number : 856-769-3900
Fax Number : 856-769-3903
Provider Business Practice Location Address
First Line : 125 EAST AVE
Second Line : SUITE D
City : WOODSTOWN
State : NJ
Zip : 08098-1351
Country : US
Telephone Number : 856-769-3900
Fax Number : 856-769-3903
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2006
Last Update Date : 05/03/2016

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