Provider Demographics
NPI:1821021593
Name:SOUTH CUMBERLAND MEDICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:SOUTH CUMBERLAND MEDICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:K
Authorized Official - Last Name:TUGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-451-4414
Mailing Address - Street 1:215 BACK NECK RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-6834
Mailing Address - Country:US
Mailing Address - Phone:856-451-4414
Mailing Address - Fax:856-451-2052
Practice Address - Street 1:215 BACK NECK RD
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-6834
Practice Address - Country:US
Practice Address - Phone:856-451-4414
Practice Address - Fax:856-451-2052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ13551OtherAETNA
NJ3423301Medicaid
NJ075720Medicare PIN