Dr Lisa Diane Urban, MD | |
860 S White Horse Pike, Hammonton, NJ 08037-2018 | |
(609) 567-0200 | |
(609) 567-1951 |
Full Name | Dr Lisa Diane Urban |
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Gender | Female |
Speciality | Pediatrics |
Location | 860 S White Horse Pike, Hammonton, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023008000 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | D0080347 (Maryland) | Secondary |
208D00000X | General Practice | C10009764 (Delaware) | Secondary |
208000000X | Pediatrics | 25MA07918100 (New Jersey) | Primary |
Entity Name | Advocare Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770538696 PECOS PAC ID: 3678562188 Enrollment ID: O20040510001217 |
Entity Name | Southern Jersey Family Medical Centers, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568473973 PECOS PAC ID: 0547170763 Enrollment ID: O20040917000774 |
Mailing Address | Practice Location Address |
---|---|
Dr Lisa Diane Urban, MD Po Box 1309, Marlton, NJ 08053-6309 Ph: (609) 567-0200 | Dr Lisa Diane Urban, MD 860 S White Horse Pike, Hammonton, NJ 08037-2018 Ph: (609) 567-0200 |
Dr. Nisrin Q Dahodwala, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 290 N White Horse Pike, Hammonton, NJ 08037 Phone: 609-567-7882 Fax: 609-567-3000 | |
Maria C Molina, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 860 S White Horse Pike, Hammonton, NJ 08037 Phone: 609-567-0200 Fax: 609-567-1951 | |
Bruce M Klein, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 860 S White Horse Pike, Hammonton, NJ 08037 Phone: 609-567-0200 Fax: 609-704-1482 | |
Dr. Dominic Chionglo Sia, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 777 S White Horse Pike, Hammonton, NJ 08037 Phone: 609-567-0608 |