Organization
BANCROFT, A NEW JERSEY NONPROFIT CORPORATION
Active
Organization
BANCROFT, A NEW JERSEY NONPROFIT CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONI PERGOLIN (PRESIDENT / CEO)
(856) 348-1175
Entity
Organization
Contact information
Practice address
1255 CALDWELL RD, CHERRY HILL, NJ 08034-3220
(856) 348-1175
(856) 375-8358
Mailing address
3900 CHURCH RD, MOUNT LAUREL, NJ 08054-1108
(800) 774-5516
(856) 429-4755
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
PRF101
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500549
MEDICARE PTAN
NJ
Enumeration date
08/23/2016
Last updated
11/08/2023
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