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Organization
SOUTH JERSEY SPORTS MEDICINE CENTER PC
Active
Organization
SOUTH JERSEY SPORTS MEDICINE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT FALCONIERO DO (MANAGING MEMBER)
(609) 703-5097
Entity
Organization
Contact information
Practice address
556 EGG HARBOR RD, SUITE A, SEWELL, NJ 08080-2326
(856) 589-0650
Mailing address
556 EGG HARBOR RD, SUITE A, SEWELL, NJ 08080-2326
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
25MB04705300
NJ
Other
Enumeration date
10/06/2016
Last updated
11/21/2016
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