1083943872 NPI number — SOUTH JERSEY FAMILY & SPECIALTY MEDICINE LLC

Table of content: ALLISON DALY SCHERER MA, NCC, LPC (NPI 1982929824)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083943872 NPI number — SOUTH JERSEY FAMILY & SPECIALTY MEDICINE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH JERSEY FAMILY & SPECIALTY MEDICINE 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:
1083943872
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2906 ROUTE 130 N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DELRAN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08075-2521
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-764-4115
Provider Business Mailing Address Fax Number:
856-764-4116

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2906 ROUTE 130
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DELRAN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08075-2521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-764-4115
Provider Business Practice Location Address Fax Number:
856-764-4116
Provider Enumeration Date:
12/08/2009

Additional Information

Authorized Official

Authorized Official Last Name:
HUSSAIN
Authorized Official First Name:
NEIL
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
856-764-4115

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  25MB07370900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: 25MA08374000 , 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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