Individual
ETHAN WILLIAM GARYSON THIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
401 KINGS HWY S, CHERRY HILL, NJ 08034-2500
(856) 209-0447
Mailing address
1 FEDERAL ST STE 200, CAMDEN, NJ 08103-1088
(848) 288-6935
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ14996900
NJ
Other
Enumeration date
06/11/2024
Last updated
03/31/2026
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