1659311934 NPI number — JAMES WURZER MD

Table of content: JAMES WURZER MD (NPI 1659311934)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659311934 NPI number — JAMES WURZER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WURZER
Provider First Name:
JAMES
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1659311934
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2500 ENGLISH CREEK AVE STE 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EGG HARBOR TOWNSHIP
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08234-5598
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-677-7700
Provider Business Mailing Address Fax Number:
609-677-7701

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 ENGLISH CREEK AVE
Provider Second Line Business Practice Location Address:
BUILDING 400
Provider Business Practice Location Address City Name:
EGG HARBOR TOWNSHIP
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08234-5549
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-652-3417
Provider Business Practice Location Address Fax Number:
609-652-3538
Provider Enumeration Date:
06/07/2006

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: 2085R0001X , with the licence number:  25MA07083100 , 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)

  • Identifier: 2361287 . This is a "USHC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 5109875004 . This is a "CIGNA HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 8232504 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2046024000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P2361725 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1165662 . This is a "HORIZON MERCY" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2046024000 . This is a "IBC/KHPE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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