Provider Demographics
NPI:1689951964
Name:JAPRIA HEALTH LLC
Entity Type:Organization
Organization Name:JAPRIA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAPATA
Authorized Official - Middle Name:
Authorized Official - Last Name:AVENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-203-6767
Mailing Address - Street 1:204 BRADLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BELLMAWR
Mailing Address - State:NJ
Mailing Address - Zip Code:08031-1303
Mailing Address - Country:US
Mailing Address - Phone:856-203-6767
Mailing Address - Fax:856-432-1632
Practice Address - Street 1:204 BRADLEY AVE
Practice Address - Street 2:
Practice Address - City:BELLMAWR
Practice Address - State:NJ
Practice Address - Zip Code:08031-1303
Practice Address - Country:US
Practice Address - Phone:856-203-6767
Practice Address - Fax:856-432-1632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB03350400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty