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Organization
DR. EDWIN A. JENSEN, D.O., P.A.
Active
Organization
DR. EDWIN A. JENSEN, D.O., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN ARNT JENSEN D.O. (PHYSICIAN)
(856) 963-2187
Entity
Organization
Contact information
Practice address
602 S BROADWAY, CAMDEN, NJ 08103-1222
(856) 963-2187
(856) 225-1913
Mailing address
602 S BROADWAY, CAMDEN, NJ 08103-1222
(856) 963-2187
(856) 225-1913
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB02501900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01000075601
AMERICHOICE
NJ
01
—
0106612001
AMERIHEALTH
NJ
05
—
2787008
—
NJ
01
—
32866
AMERIGROUP
NJ
Enumeration date
08/11/2006
Last updated
10/10/2007
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