Provider Demographics
NPI:1952302259
Name:OPPENHEIM, JEFFREY CHARLES (BA, MMS, MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:CHARLES
Last Name:OPPENHEIM
Suffix:
Gender:M
Credentials:BA, MMS, MD
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Mailing Address - Street 1:100 CENTURY PKWY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1149
Mailing Address - Country:US
Mailing Address - Phone:856-380-2400
Mailing Address - Fax:856-234-7870
Practice Address - Street 1:100 CENTURY PKWY
Practice Address - Street 2:SUITE 140
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1149
Practice Address - Country:US
Practice Address - Phone:856-380-2400
Practice Address - Fax:856-234-7870
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2015-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA3216900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1244108Medicaid
NJ070089Medicare PIN
E67582Medicare UPIN
NJ0076229000OtherKEYSTONE EAST
NJ1244108Medicaid