Individual
JOHN E BEVILACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 COOPER PLZ, SUITE 320, CAMDEN, NJ 08103-1438
(856) 616-1337
Mailing address
3 COOPER PLZ, SUITE 320, CAMDEN, NJ 08103-1438
(856) 616-1337
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MA15271
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HEAKLTHNET
3K6117
NJ
Enumeration date
10/12/2006
Last updated
09/23/2010
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