| Emily Takhtarov, | |
|
141 Route 70 E Ste B, Marlton, NJ 08053-1855 | |
| (856) 596-9057 | |
| (856) 596-0837 |
| Full Name | Emily Takhtarov |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Adult Health |
| Location | 141 Route 70 E Ste B, Marlton, 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 |
|---|---|---|---|
| 1659119220 | NPI | - | NPPES |
| 1028596 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LA2200X | Nurse Practitioner - Adult Health | 26NJ15114400 (New Jersey) | Primary |
| 163W00000X | Registered Nurse | 26NR26058900 (New Jersey) | Secondary |
| Entity Name | Virtua Medical Group, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649226515 PECOS PAC ID: 9830222397 Enrollment ID: O20100804000338 |
| Mailing Address | Practice Location Address |
|---|---|
| Emily Takhtarov, 141 Route 70 E Ste B, Marlton, NJ 08053-1855 Ph: () - | Emily Takhtarov, 141 Route 70 E Ste B, Marlton, NJ 08053-1855 Ph: (856) 596-9057 |
Dorothy Westlake, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1001 Rt. 73 North, Upper Level A & Main Level, Marlton, NJ 08053 Phone: 856-988-3444 | |
Phenita Sammantha Mouzon, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 777 Route 70 E Ste G101, Marlton, NJ 08053 Phone: 856-818-4020 | |
Mrs. Yingqiao Chen, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2003 Lincoln Dr W Ste B, Marlton, NJ 08053 Phone: 856-886-8839 Fax: 856-210-1874 | |
Ms. Fleurdeliz Alabanzas Germodo, N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 141 Route 70 E Ste B, Marlton, NJ 08053 Phone: 856-596-9057 | |
Ms. Maria Terresa Pauciello, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1001 Route 73 N Upper Level A & Main Level, Marlton, NJ 08053 Phone: 856-988-3444 Fax: 856-795-3625 | |
Valerie T Cotter, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 11009 Lincoln Dr W, Marlton, NJ 08053 Phone: 856-985-9851 Fax: 856-985-9955 | |
Mrs. Nicole M Henderson-cole, MSN, APN-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 765 Route 70 E Bldg A, Marlton, NJ 08053 Phone: 856-797-4858 Fax: 856-797-4785 |