| Harkaway Llc | |
|
1220 Tilton Rd Northfield NJ 08225-1809 | |
| (609) 377-5090 | |
| Not Available |
| Full Name | Harkaway Llc |
|---|---|
| Speciality | General Practice |
| Location | 1220 Tilton Rd, Northfield, New Jersey |
| Authorized Official Name and Position | Richard Harkaway (OWNER) |
| Authorized Official Contact | 6106597511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harkaway Llc 132 Country Club Dr Moorestown NJ 08057-3974 Ph: (609) 969-7651 | Harkaway Llc 1220 Tilton Rd Northfield NJ 08225-1809 Ph: (609) 377-5090 |
| NPI Number | 1447717962 |
|---|---|
| Provider Enumeration Date | 02/21/2019 |
| Last Update Date | 02/21/2019 |
| Medicare PECOS PAC ID | 0941542120 |
|---|---|
| Medicare Enrollment ID | O20190509000452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447717962 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Denise S Trumbauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477558351 PECOS PAC ID: 6406812692 Enrollment ID: I20041209000173 |
| Provider Name | Cheryl Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093769887 PECOS PAC ID: 7517050297 Enrollment ID: I20070911000909 |
| Provider Name | Jessica L Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922583160 PECOS PAC ID: 3274879374 Enrollment ID: I20190110001677 |
| Provider Name | Nicole Bock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376107839 PECOS PAC ID: 8921333287 Enrollment ID: I20190710000769 |
| Provider Name | Linda A Russomanno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710131321 PECOS PAC ID: 5698179760 Enrollment ID: I20210811002826 |
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