Provider Demographics
NPI:1265843338
Name:SOUTH JERSEY MEDICAL CONSULTANTS
Entity Type:Organization
Organization Name:SOUTH JERSEY MEDICAL CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERSICHETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-706-9179
Mailing Address - Street 1:8 TARA DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-9553
Mailing Address - Country:US
Mailing Address - Phone:609-706-9179
Mailing Address - Fax:856-596-7146
Practice Address - Street 1:8 TARA DR
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-9553
Practice Address - Country:US
Practice Address - Phone:609-706-9179
Practice Address - Fax:856-596-7146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies