Individual
TRACY DEBIASO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
230 LAUREL HEIGHTS DRIVE, BRIDGETON, NJ 08302-3634
(856) 451-9595
(856) 451-4130
Mailing address
230 LAUREL HEIGHTS DRIVE, BRIDGETON, NJ 08302-3634
(856) 451-9595
(856) 451-4130
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA06258600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1469012002
CIGNA
—
05
—
6605907
—
NJ
01
—
F16382
HEALTH NET
—
01
—
J3322
HORIZON
—
Enumeration date
05/27/2006
Last updated
12/14/2010
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