1063497279 NPI number — DR. HANNAH ZARROLI M.D.

Table of content: DR. HANNAH ZARROLI M.D. (NPI 1063497279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063497279 NPI number — DR. HANNAH ZARROLI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZARROLI
Provider First Name:
HANNAH
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ELTON
Provider Other First Name:
HANNAH
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1063497279
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7000 ATRIUM WAY
Provider Second Line Business Mailing Address:
SUITE 6
Provider Business Mailing Address City Name:
MOUNT LAUREL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-291-6818
Provider Business Mailing Address Fax Number:
856-291-6819

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 OLD MARLTON PIKE
Provider Second Line Business Practice Location Address:
SUITE 111
Provider Business Practice Location Address City Name:
MEDFORD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08055-8772
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-953-7111
Provider Business Practice Location Address Fax Number:
609-953-1544
Provider Enumeration Date:
12/09/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  25MA07950200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0079146 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".