Individual
DR. JESUSITA HERCO GUEVARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
212 W ROUTE 38, SUITE 400, MOORESTOWN, NJ 08057-3238
(856) 235-0264
(856) 235-4635
Mailing address
212 W ROUTE 38 STE 400, MOORESTOWN, NJ 08057-3259
(856) 235-0264
(856) 235-4635
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA04812300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7002301
—
NJ
Enumeration date
05/13/2006
Last updated
07/31/2013
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