Provider Demographics
NPI:1144770975
Name:VIRTUA MEDICAL GROUP, PA
Entity Type:Organization
Organization Name:VIRTUA MEDICAL GROUP, PA
Other - Org Name:VIRTUA EXPRESS URGENT CARE - MEDFORD
Other - Org Type:Other Name
Authorized Official - Title/Position:EVP; SYSTEM CHIEF CLINICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:MATSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:856-355-0340
Mailing Address - Street 1:301 LIPPINCOTT DR STE 120
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0346
Practice Address - Street 1:128 ROUTE 70
Practice Address - Street 2:SUITE 1
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055
Practice Address - Country:US
Practice Address - Phone:609-367-0900
Practice Address - Fax:609-367-0901
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIRTUA MEDICAL GROUP, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-05
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care