Organization
SOUTH JERSEY SPORTS MEDICINE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT FALCONIERO DO (MANAGING MEMBER)
(609) 703-5097
Entity
Organization
Contact information
Practice address
556 EGG HARBOR RD, SUITE A, SEWELL, NJ 08080-2326
(856) 589-0650
Mailing address
556 EGG HARBOR RD, SUITE A, SEWELL, NJ 08080-2326
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
25MB04705300
NJ
Other
Enumeration date
10/06/2016
Last updated
11/21/2016
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