Organization
SOUTH JERSEY GASTROENTEROLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN LIAKOS D.O. (PRESIDENT)
(856) 983-1900
Entity
Organization
Contact information
Practice address
406 LIPPINCOTT DR, SUITE E, MARLTON, NJ 08053-4168
(856) 983-1900
(856) 983-1914
Mailing address
406 LIPPINCOTT DR, SUITE E, MARLTON, NJ 08053-4168
(856) 983-1900
(856) 983-1914
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
207ZP0101X
Anatomic Pathology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3047407
—
NJ
Enumeration date
06/16/2006
Last updated
09/26/2013
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