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Organization
WOODBINE FAMILY MEDICAL
Active
Organization
WOODBINE FAMILY MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS JACOB (OWNER)
(609) 861-4241
Entity
Organization
Contact information
Practice address
713 DEHIRSCH AVE, WOODBINE, NJ 08270-2339
(609) 861-4241
(609) 861-1071
Mailing address
713 DEHIRSCH AVE, WOODBINE, NJ 08270-2339
(609) 861-4241
(609) 861-1071
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MB61909
NJ
363LF0000X
Family Nurse Practitioner
26NN1202500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7011008
—
NJ
Enumeration date
05/03/2011
Last updated
05/03/2011
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