Individual
PATRICK A ERVILUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NPC
Contact information
Practice address
2809 RIVER RD, CAMDEN, NJ 08105-4426
(856) 966-8088
(856) 966-8089
Mailing address
405 W COUNTRY CLUB DR, WESTAMPTON, NJ 08060-4741
(609) 702-5808
(609) 702-5809
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
26NN10322000
NJ
363LF0000X
Family Nurse Practitioner
Primary
26NN10322000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7523203
—
NJ
Enumeration date
07/14/2005
Last updated
08/04/2008
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