| Cmc Department Of Medicine Group Pa | |
|
1 Plaza Dr Chapel Heights & Hurfville-cross Keys Roads Sewell NJ 08080-9207 | |
| (856) 270-4080 | |
| (856) 270-4085 |
| Full Name | Cmc Department Of Medicine Group Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1 Plaza Dr, Sewell, New Jersey |
| Authorized Official Name and Position | Robert Mcmullen (EVP MANAGED CARE) |
| Authorized Official Contact | 8563422921 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cmc Department Of Medicine Group Pa 3 Cooper Plz Suite 502 Camden NJ 08103-1438 Ph: (856) 342-2921 | Cmc Department Of Medicine Group Pa 1 Plaza Dr Chapel Heights & Hurfville-cross Keys Roads Sewell NJ 08080-9207 Ph: (856) 270-4080 |
| NPI Number | 1437281771 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 07/01/2008 |
| Medicare PECOS PAC ID | 2163335878 |
|---|---|
| Medicare Enrollment ID | O20160208001039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437281771 | NPI | - | NPPES |
| 2265447000 | Other | NJ | NEUROLOGY GRP# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Bradley P Grayum |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831250992 PECOS PAC ID: 5193747608 Enrollment ID: I20051228000080 |
| Provider Name | Pallav Mehta |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1720126170 PECOS PAC ID: 7012017817 Enrollment ID: I20070710000015 |
| Provider Name | Ann Christian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689829095 PECOS PAC ID: 4284791088 Enrollment ID: I20090323000404 |
| Provider Name | Michael Rachshtut |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1912153792 PECOS PAC ID: 2163575002 Enrollment ID: I20090724000614 |
| Provider Name | Amy Colcher |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174554901 PECOS PAC ID: 6305972670 Enrollment ID: I20100326000244 |
| Provider Name | Christina Clay |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1326029042 PECOS PAC ID: 8527082148 Enrollment ID: I20101108000337 |
| Provider Name | Jenia Jenab-wolcott |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1619039260 PECOS PAC ID: 9830297571 Enrollment ID: I20101207000038 |
| Provider Name | Christina Brus |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1265641120 PECOS PAC ID: 6901076504 Enrollment ID: I20110908001847 |
| Provider Name | Danielle Lajoie Behrens |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1851699805 PECOS PAC ID: 7113145459 Enrollment ID: I20140827002164 |
| Provider Name | Ly T Ngo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003077074 PECOS PAC ID: 6709028210 Enrollment ID: I20150205000609 |
| Provider Name | Ahmed Kamel Abou Hussein |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1841502275 PECOS PAC ID: 3870734544 Enrollment ID: I20160812000269 |
| Provider Name | Sushil Ghimire |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912314840 PECOS PAC ID: 9032400114 Enrollment ID: I20170802002437 |
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