| Woodbury Medical Office Pa | |
|
50 Cooper St Woodbury NJ 08096-4618 | |
| (856) 848-8081 | |
| (856) 848-1577 |
| Full Name | Woodbury Medical Office Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 50 Cooper St, Woodbury, New Jersey |
| Authorized Official Name and Position | Anthony W Bonett (PHYSICIAN) |
| Authorized Official Contact | 8568488081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodbury Medical Office Pa 50 Cooper St Woodbury NJ 08096-4618 Ph: (856) 848-8081 | Woodbury Medical Office Pa 50 Cooper St Woodbury NJ 08096-4618 Ph: (856) 848-8081 |
| NPI Number | 1134171150 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 05/03/2017 |
| Medicare PECOS PAC ID | 8820130768 |
|---|---|
| Medicare Enrollment ID | O20100121000289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134171150 | NPI | - | NPPES |
| 0766671001 | Other | NJ | AMERIHEALTH GROUP NUMBER |
| 0010148 | Other | NJ | AETNA GROUP NUMBER |
| 2600307 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MA054063 (New Jersey) | Primary |
| Provider Name | Anthony W Bonett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427059914 PECOS PAC ID: 1254376817 Enrollment ID: I20050623000587 |
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