Organization
NASPAC-NJ PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE BOGDOL AM (DIRECTOR REVENUE CYCLE)
(609) 845-3988
Entity
Organization
Contact information
Practice address
2325 MARYLAND RD STE 100, WILLOW GROVE, PA 19090-1758
(215) 657-1315
(215) 659-8964
Mailing address
404 CREEK CROSSING BLVD STE 404, HAINESPORT, NJ 08036-2768
(609) 845-3988
(609) 288-6078
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0002X
Clinic Pharmacy
—
—
Other
Enumeration date
08/29/2019
Last updated
04/01/2026
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