# WOODBURY MEDICAL OFFICE PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134171150
- **Authorized official:** DR. ANTHONY W BONETT M.D. (PHYSICIAN)
- **Authorized official phone:** (856) 848-8081

## Contact information

- **Practice address:** 50 COOPER ST, WOODBURY, NJ 08096-4618
- **Practice address phone:** (856) 848-8081
- **Practice address fax:** (856) 848-1577
- **Mailing address:** 50 COOPER ST, WOODBURY, NJ 08096-4618
- **Mailing address phone:** (856) 848-8081
- **Mailing address fax:** (856) 848-1577

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | MA054063 | NJ | Yes |

## Other

- **Enumeration date:** 05/17/2006
- **Last updated:** 05/03/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0010148 | AETNA GROUP NUMBER | NJ |
| 01 | — | 0766671001 | AMERIHEALTH GROUP NUMBER | NJ |
| 05 | — | 2600307 | — | NJ |