1497024343 NPI number — THERESA J WHITING APN-ANESTHESIA

Table of content: THERESA J WHITING APN-ANESTHESIA (NPI 1497024343)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497024343 NPI number — THERESA J WHITING APN-ANESTHESIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITING
Provider First Name:
THERESA
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APN-ANESTHESIA
Provider Gender Code:
F

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:
1497024343
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 DIAMOND HILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BERKELEY HEIGHTS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07922-2104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-273-4300
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
136 ROUTE 73 STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VOORHEES
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08043-9598
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-388-2778
Provider Business Practice Location Address Fax Number:
856-424-7529
Provider Enumeration Date:
12/21/2011

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: 367500000X , with the licence number:  26NJ00359100 , 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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