Provider Demographics
NPI:1841204849
Name:MLFP LLC
Entity Type:Organization
Organization Name:MLFP LLC
Other - Org Name:MT LAUREL FAMILY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:TERMINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-778-4756
Mailing Address - Street 1:204 ARK RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3100
Mailing Address - Country:US
Mailing Address - Phone:856-778-4756
Mailing Address - Fax:856-778-1742
Practice Address - Street 1:204 ARK RD
Practice Address - Street 2:SUITE 103
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-3100
Practice Address - Country:US
Practice Address - Phone:856-778-4756
Practice Address - Fax:856-778-1742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3033902Medicaid
NJ=========OtherTAX ID NUMBER
NJ=========OtherTAX ID NUMBER