| Foda Family Practice Llc | |
|
1939 Marlton Pike E Ste 250 Cherry Hill NJ 08003-4507 | |
| (856) 985-9106 | |
| (609) 228-7604 |
| Full Name | Foda Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1939 Marlton Pike E Ste 250, Cherry Hill, New Jersey |
| Authorized Official Name and Position | Randa B Foda (PHYSCIAN) |
| Authorized Official Contact | 8569859100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foda Family Practice Llc 1939 Marlton Pike E Ste 250 Cherry Hill NJ 08003-4507 Ph: (856) 985-9106 | Foda Family Practice Llc 1939 Marlton Pike E Ste 250 Cherry Hill NJ 08003-4507 Ph: (856) 985-9106 |
| NPI Number | 1508073016 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 06/07/2023 |
| Medicare PECOS PAC ID | 7012992977 |
|---|---|
| Medicare Enrollment ID | O20040623001088 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508073016 | NPI | - | NPPES |
| 0023442 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MA07595300 (New Jersey) | Primary |
| Provider Name | Randa B Foda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881629178 PECOS PAC ID: 7517942451 Enrollment ID: I20040623000960 |
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