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Individual

DR. SEBLEWONGEL BULCHA DEBOSSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2605 SHORE RD, NORTHFIELD, NJ 08225-2136
(609) 365-5300
Mailing address
1 E. NEW YORK AVE, 4TH FLOOR ADMIN, SOMERS POINT, NJ 08244-1600
(609) 653-3265
(646) 312-0481

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
255018
NY
207Q00000X
Family Medicine Physician
Primary
25MA09289300
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0437433
NJ
Enumeration date
05/30/2008
Last updated
11/14/2022
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