Provider Demographics
NPI:1386839603
Name:DENDRINOS MEDICAL ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:DENDRINOS MEDICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ARISTIDIS
Authorized Official - Last Name:DENDRINOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-563-1600
Mailing Address - Street 1:PO BOX 2268
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08362-2268
Mailing Address - Country:US
Mailing Address - Phone:856-205-1273
Mailing Address - Fax:
Practice Address - Street 1:2020 E CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08361-8432
Practice Address - Country:US
Practice Address - Phone:856-563-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ020348Medicare PIN