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Individual

ALFRED VASQUEZ ENRIQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
128 ROUTE 70 STE 1, MEDFORD, NJ 08055-2371
(609) 367-0900
(609) 367-0901
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA09878600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0550582
NJ
Enumeration date
03/26/2013
Last updated
01/03/2025
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