1669795878 NPI number — AIDS COALITION OF SOUTHERN NEW JERSEY

Table of content: NATHAN MICHAEL MATWICK D.O. (NPI 1083062111)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669795878 NPI number — AIDS COALITION OF SOUTHERN NEW JERSEY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AIDS COALITION OF SOUTHERN NEW JERSEY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669795878
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 ESSEX AVE
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
BELLMAWR
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08031-2488
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-933-9500
Provider Business Mailing Address Fax Number:
856-933-9515

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 ESSEX AVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
BELLMAWR
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08031-2488
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-933-9500
Provider Business Practice Location Address Fax Number:
856-933-9515
Provider Enumeration Date:
03/03/2010

Additional Information

Authorized Official

Authorized Official Last Name:
SALMON
Authorized Official First Name:
NORAH
Authorized Official Middle Name:
Authorized Official Title or Position:
GRANTS COORDINATOR
Authorized Official Telephone Number:
856-933-9500

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2024 www.npivalidator.com