| 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 |
| Location | 4510 Church Rd, Mount Laurel, New Jersey |
| Authorized Official Name and Position | Thomas Yon Lee (OWNER) |
| Authorized Official Contact | 8564390060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| 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 |
| Medicare PECOS PAC ID | 3971741133 |
|---|---|
| Medicare Enrollment ID | O20130529000525 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417393943 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | 25MA07756900 (New Jersey) | Primary |
| Provider Name | Fran Rosenfeld |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619079761 PECOS PAC ID: 4082681481 Enrollment ID: I20040915000234 |
| Provider Name | Thomas Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285632950 PECOS PAC ID: 7214997014 Enrollment ID: I20041015000718 |
| Provider Name | Robin Westcott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972595577 PECOS PAC ID: 1456314574 Enrollment ID: I20041110000205 |
| Provider Name | Jan P Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174696462 PECOS PAC ID: 0446356554 Enrollment ID: I20070507000548 |
| Provider Name | Stephanie M Moon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306038955 PECOS PAC ID: 2264502780 Enrollment ID: I20080610000094 |
| Provider Name | Josephine C Westenberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679624605 PECOS PAC ID: 6305918368 Enrollment ID: I20080708000429 |
| Provider Name | Stephanie K Sapio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528296514 PECOS PAC ID: 5294874046 Enrollment ID: I20091208000254 |
| Provider Name | Christine A. C. Forward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780687004 PECOS PAC ID: 8729113030 Enrollment ID: I20100311000719 |
| Provider Name | Sally B Maurer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316943244 PECOS PAC ID: 2365577541 Enrollment ID: I20100312000462 |
| Provider Name | Bertha Roser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730418609 PECOS PAC ID: 4981730892 Enrollment ID: I20100330001198 |
| Provider Name | Cynthia M Tourigian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114258613 PECOS PAC ID: 2264566934 Enrollment ID: I20100817000557 |
| Provider Name | Margaret Moloney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104197029 PECOS PAC ID: 0446412670 Enrollment ID: I20120503000419 |
| Provider Name | Rosario Alfaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053686931 PECOS PAC ID: 5496997678 Enrollment ID: I20130819000322 |
| Provider Name | Elease E Coney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851727150 PECOS PAC ID: 7214169705 Enrollment ID: I20140416000435 |
| Provider Name | Christina M Defamio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134428527 PECOS PAC ID: 6800118217 Enrollment ID: I20141212001613 |
| Provider Name | Deborah J Larmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639388556 PECOS PAC ID: 7618276494 Enrollment ID: I20160817002141 |
| Provider Name | Beth A Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487106290 PECOS PAC ID: 0941580955 Enrollment ID: I20161209000151 |
| Provider Name | Jennifer L Merlino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407393093 PECOS PAC ID: 1557647633 Enrollment ID: I20170405000528 |
| Provider Name | Elsie A Jolade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689170235 PECOS PAC ID: 9234493982 Enrollment ID: I20180503001704 |
| Provider Name | Ann M Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912480609 PECOS PAC ID: 7810231057 Enrollment ID: I20181129000967 |
| Provider Name | Gabrielle D Jimenez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457812026 PECOS PAC ID: 4880935923 Enrollment ID: I20190418000099 |
Family Practice Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3814 Church Rd, Mount Laurel, NJ 08054 Phone: 856-231-9792 | |
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