1750829396 NPI number — CORE COUNSELING SOUTH JERSEY, LLC

Table of content: MR. HSIAO TUNG HO RPH (NPI 1952470304)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750829396 NPI number — CORE COUNSELING SOUTH JERSEY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORE COUNSELING SOUTH JERSEY, LLC
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:
1750829396
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 WHITE HORSE RD
Provider Second Line Business Mailing Address:
SUITE 904
Provider Business Mailing Address City Name:
VOORHEES
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08043-4406
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-866-6331
Provider Business Mailing Address Fax Number:
856-772-9674

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 WHITE HORSE RD
Provider Second Line Business Practice Location Address:
SUITE 904
Provider Business Practice Location Address City Name:
VOORHEES
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08043-4406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-866-6331
Provider Business Practice Location Address Fax Number:
856-772-9674
Provider Enumeration Date:
02/02/2017

Additional Information

Authorized Official

Authorized Official Last Name:
MONDELBLATT
Authorized Official First Name:
ADAM
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
856-866-6331

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  37PC00485700 , 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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