Organization
MEDFORD SURGICAL PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA L KOWALEWSKI (BILLING MANAGER)
(856) 753-0913
Entity
Organization
Contact information
Practice address
212 CREEK CROSSING BLVD, HAINESPORT, NJ 08036-2766
(609) 267-1004
(609) 267-1044
Mailing address
212 CREEK CROSSING BLVD, HAINESPORT, NJ 08036-2766
(609) 267-1004
(609) 267-1044
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3458806
—
NJ
Enumeration date
12/08/2006
Last updated
05/22/2009
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