Organization
DR. EDWIN A. JENSEN, D.O., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN ARNT JENSEN D.O. (PHYSICIAN)
(856) 963-2187
Entity
Organization
Contact information
Practice address
602 S BROADWAY, CAMDEN, NJ 08103-1222
(856) 963-2187
(856) 225-1913
Mailing address
602 S BROADWAY, CAMDEN, NJ 08103-1222
(856) 963-2187
(856) 225-1913
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB02501900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01000075601
AMERICHOICE
NJ
01
—
0106612001
AMERIHEALTH
NJ
05
—
2787008
—
NJ
01
—
32866
AMERIGROUP
NJ
Enumeration date
08/11/2006
Last updated
10/10/2007
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