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CMC DEPARTMENT OF MEDCINE

Clinical Neuropsychologist

Camden, New Jersey

Provider NPI: 1770774481

Organization Information:
Organization Name:  CMC DEPARTMENT OF MEDCINE
Organization is not Subpart
Authorized Official:  ROBERT  MCMULLEN  EVP MANAGED CARE  856-3422921

Practice Location:
3 COOPER PLZ SUITE 215 (NEUROLOGY) CAMDEN, NJ 08103 US
Tel: 856-342-2445  Fax: 856-964-0504

Business Mailing Address:
3 COOPER PLZ SUITE 502 CAMDEN, NJ 08103 US
Tel: 856-342-2921  Fax: 856-968-8499

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist

Other Provider Identifiers:

IssuerNumberStateType
AMERIHEALTH GROUP#2835974000NJ01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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