Individual
LUIS A CERVANTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 PLAZA COURT, EAST STROUDSBURG, PA 18301-3124
(570) 426-2758
(570) 426-2665
Mailing address
110 MARTER AVE, SUITE 202, MOORESTOWN, NJ 08057-3124
(856) 727-1000
(856) 727-1059
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
MA44094
NJ
207T00000X
Neurological Surgery Physician
Primary
MD462928
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0108926000
AMERIHEALTH HMO
NJ
05
—
1034000720003
—
PA
01
—
34701
AETNA/USHC
NJ
01
—
620691PZP
MEDICARE
PA
01
—
E01236
AMERIHEALTH ADMINISTRATOR
NJ
Enumeration date
06/23/2005
Last updated
11/27/2018
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