| Pennsuaken Family Practice, Pc | |
|
5647 Westfield Ave Pennsauken NJ 08110-1836 | |
| (856) 663-1470 | |
| (856) 663-3409 |
| Full Name | Pennsuaken Family Practice, Pc |
|---|---|
| Speciality | General Practice |
| Location | 5647 Westfield Ave, Pennsauken, New Jersey |
| Authorized Official Name and Position | Herman P Cohen (OWNER) |
| Authorized Official Contact | 8566631470 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pennsuaken Family Practice, Pc 5647 Westfield Ave Pennsauken NJ 08110-1836 Ph: (856) 663-1470 | Pennsuaken Family Practice, Pc 5647 Westfield Ave Pennsauken NJ 08110-1836 Ph: (856) 663-1470 |
| NPI Number | 1518187392 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 05/13/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518187392 | NPI | - | NPPES |
| 0964523000 | Other | PA | KEYSTONE |
| 3370 | Other | PA | AETNA |
| 857996 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 61259 (New Jersey) | Primary |
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