Organization
WEDGEWOOD FAMILY PRACTICE ASSOC P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BARBARA M BRUSCO (PRACTICE ADMINSTRATOR)
(856) 589-4610
Entity
Organization
Contact information
Practice address
302 HURFFVILLE CROSSKEYS RD, SUITE A1, SEWELL, NJ 08080-9206
(856) 589-4610
(856) 589-1624
Mailing address
302 HURFFVILLE CROSSKEYS RD, SUITE A1, SEWELL, NJ 08080-9206
(856) 589-4610
(856) 589-1624
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2785005
—
NJ
Enumeration date
06/22/2006
Last updated
09/19/2014
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