Provider Demographics
NPI:1588601967
Name:COLLINGSWOOD FAMILY MEDICINE, P.A.
Entity Type:Organization
Organization Name:COLLINGSWOOD FAMILY MEDICINE, P.A.
Other - Org Name:JASON N. MORALEDA, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:N
Authorized Official - Last Name:MORALEDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-858-3375
Mailing Address - Street 1:275 HADDON AVE
Mailing Address - Street 2:COLLINGSWOOD MEDICAL CENTER
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-1121
Mailing Address - Country:US
Mailing Address - Phone:856-858-3375
Mailing Address - Fax:
Practice Address - Street 1:275 HADDON AVE
Practice Address - Street 2:COLLINGSWOOD MEDICAL CENTER
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-1121
Practice Address - Country:US
Practice Address - Phone:856-858-3375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty