Organization
GEPS PHYSICIAN GROUP OF NEW JERSEY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC SHAPIRO (VICE PRESIDENT)
(410) 832-7790
Entity
Organization
Contact information
Practice address
101 E STATE ST, KENNETT SQUARE, PA 19348
(610) 925-4157
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
869802
—
NJ
Enumeration date
07/19/2006
Last updated
07/10/2018
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