1730450040 NPI number — MEGHAN MURPHY SCHMELZER CARUSO, DO, L.L.C.

Table of content: MEDIA ISMAEL M.D. (NPI 1922530294)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730450040 NPI number — MEGHAN MURPHY SCHMELZER CARUSO, DO, L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEGHAN MURPHY SCHMELZER CARUSO, DO, L.L.C.
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:
1730450040
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9002 LINCOLN DR W STE D
Provider Second Line Business Mailing Address:
SUITE D
Provider Business Mailing Address City Name:
MARLTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08053-3204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-983-4646
Provider Business Mailing Address Fax Number:
856-983-4760

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9002 LINCOLN DR W STE D
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
MARLTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08053-3204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-983-4646
Provider Business Practice Location Address Fax Number:
856-983-4760
Provider Enumeration Date:
01/18/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ACKERMAN
Authorized Official First Name:
MARIE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
RN
Authorized Official Telephone Number:
856-983-4646

Provider Taxonomy Codes

  • Taxonomy code: 207NS0135X , with the licence number:  25MB06858000 , 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)





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