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Individual

GILENO OLIVEIRA FONSECA FILHO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1001 SHEPPARD RD, VOORHEES, NJ 08043-4796
(856) 772-1617
Mailing address
570 EGG HARBOR RD STE B2, SEWELL, NJ 08080-2359
(856) 270-6145
(856) 589-3443

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
25MA11062200
NJ
207Y00000X
Otolaryngology Physician
MD473885
PA

Other

Enumeration date
04/10/2016
Last updated
06/30/2022
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