| Phoenix Housecall Associates Of South Jersey | |
|
4510 Church Rd Mount Laurel NJ 08054-2210 | |
| (856) 439-0060 | |
| (856) 452-0344 |
| Full Name | Phoenix Housecall Associates Of South Jersey |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 4510 Church Rd, Mount Laurel, New Jersey |
| Authorized Official Name and Position | Thomas Yon Lee (OWNER) |
| Authorized Official Contact | 8564390060 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Housecall Associates Of South Jersey 4510 Church Rd Mount Laurel NJ 08054-2210 Ph: (856) 439-0060 | Phoenix Housecall Associates Of South Jersey 4510 Church Rd Mount Laurel NJ 08054-2210 Ph: (856) 439-0060 |
| NPI Number | 1417393943 |
|---|---|
| Provider Enumeration Date | 05/10/2013 |
| Last Update Date | 10/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417393943 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | 25MA07756900 (New Jersey) | Primary |
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