| Mobile Physician Group, Pc | |
|
231 High St Fl 1 Mount Holly NJ 08060-1450 | |
| (609) 534-5998 | |
| (609) 488-6023 |
| Full Name | Mobile Physician Group, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 231 High St Fl 1, Mount Holly, New Jersey |
| Authorized Official Name and Position | Carolyn M Cavuto-carnivale (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6095345998 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Physician Group, Pc 231 High St Fl 1 Mount Holly NJ 08060-1450 Ph: (609) 534-5998 | Mobile Physician Group, Pc 231 High St Fl 1 Mount Holly NJ 08060-1450 Ph: (609) 534-5998 |
| NPI Number | 1750647715 |
|---|---|
| Provider Enumeration Date | 04/04/2012 |
| Last Update Date | 05/31/2012 |
| Medicare PECOS PAC ID | 9234392903 |
|---|---|
| Medicare Enrollment ID | O20120516000087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750647715 | NPI | - | NPPES |
| 0289736 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MB63668 (New Jersey) | Primary |
| Provider Name | Carolyn M. Cavuto Wilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295720035 PECOS PAC ID: 7214007517 Enrollment ID: I20080529000290 |
| Provider Name | Michele Lanza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871680603 PECOS PAC ID: 0244365450 Enrollment ID: I20100312000679 |
| Provider Name | Wyndham Pursley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790784429 PECOS PAC ID: 5597822635 Enrollment ID: I20110427000169 |
| Provider Name | Matthew W Kaspar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588948244 PECOS PAC ID: 1759554330 Enrollment ID: I20111026000521 |
| Provider Name | Jessica L. Ruiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134490006 PECOS PAC ID: 5799943973 Enrollment ID: I20120220000184 |
| Provider Name | Gina A Tucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548670995 PECOS PAC ID: 4981826005 Enrollment ID: I20141105001008 |
| Provider Name | Dawn J Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558731497 PECOS PAC ID: 3577863430 Enrollment ID: I20151125000151 |
| Provider Name | Ladawna R Leeth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306212774 PECOS PAC ID: 2668777061 Enrollment ID: I20160223001507 |
| Provider Name | Courtney Jay Tarpy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790295608 PECOS PAC ID: 0345503421 Enrollment ID: I20180718002942 |
| Provider Name | Elizabeth A Donnelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477116028 PECOS PAC ID: 0648505115 Enrollment ID: I20190708000103 |
| Provider Name | Aliya Fayazi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265038723 PECOS PAC ID: 9234542879 Enrollment ID: I20210308000956 |
| Provider Name | Rachene Roanna Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760068159 PECOS PAC ID: 3476937194 Enrollment ID: I20220830002251 |
| Provider Name | Nicole Marie Carnivale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285410399 PECOS PAC ID: 0345694147 Enrollment ID: I20230927004090 |
Dr. Philip H. Varner Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Madison Ave, Mount Holly, NJ 08060 Phone: 609-702-9103 Fax: 609-702-9122 | |
Clare Medical Of New Jersey Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 137 High St Fl 2a, Mount Holly, NJ 08060 Phone: 609-474-0120 Fax: 844-772-0853 | |
Medical Providers On The Go Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 231 High St, Suite 1, Mount Holly, NJ 08060 Phone: 609-534-5998 Fax: 609-488-6023 |