| Bancroft, A New Jersey Nonprofit Corporation | |
|
1255 Caldwell Rd Cherry Hill NJ 08034-3220 | |
| (856) 348-1175 | |
| (856) 375-8358 |
| Full Name | Bancroft, A New Jersey Nonprofit Corporation |
|---|---|
| Speciality | Psychologist - Intellectual & Developmental Disabilities |
| Location | 1255 Caldwell Rd, Cherry Hill, New Jersey |
| Authorized Official Name and Position | Toni Pergolin (PRESIDENT / CEO) |
| Authorized Official Contact | 8563481175 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bancroft, A New Jersey Nonprofit Corporation 3900 Church Rd Mount Laurel NJ 08054-1108 Ph: (800) 774-5516 | Bancroft, A New Jersey Nonprofit Corporation 1255 Caldwell Rd Cherry Hill NJ 08034-3220 Ph: (856) 348-1175 |
| NPI Number | 1609321256 |
|---|---|
| Provider Enumeration Date | 08/23/2016 |
| Last Update Date | 11/08/2023 |
| Certification Date | 11/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609321256 | NPI | - | NPPES |
| 500549 | Other | NJ | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | PRF101 (New Jersey) | Primary |
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