| South Jersey Medical Associates, P.a. | |
|
1504 Blackwood Clementon Rd Blackwood NJ 08012-4625 | |
| (856) 228-0144 | |
| (856) 232-0320 |
| Full Name | South Jersey Medical Associates, P.a. |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 1504 Blackwood Clementon Rd, Blackwood, New Jersey |
| Authorized Official Name and Position | Ronald George Intelisano (PRESIDENT) |
| Authorized Official Contact | 8562280144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Jersey Medical Associates, P.a. 1504 Blackwood Clementon Rd Blackwood NJ 08012-4625 Ph: (856) 228-0144 | South Jersey Medical Associates, P.a. 1504 Blackwood Clementon Rd Blackwood NJ 08012-4625 Ph: (856) 228-0144 |
| NPI Number | 1669525960 |
|---|---|
| Provider Enumeration Date | 01/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669525960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MB05610900 (New Jersey) | Primary |
| 207RG0100X | Internal Medicine - Gastroenterology | MB05610900 (New Jersey) | Primary |
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