Umdnjsom

NPI #1982916284 in Haddon Heights, New Jersey

Provider Information

NPI Number: 1982916284
Entity Type: Organization
Organization Name: Umdnjsom
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jul 2, 2010
Last Updated: Jul 2, 2010

Practice Location

Address: 401 E ATLANTIC AVE APT 323
City: Haddon Heights
State: New Jersey
ZIP Code: 08035-1740
Phone: (717) 725-6750

Authorized Official

Name: DR. ZACHARY ANDREW ICHTER
Title: INTERN
Phone: (717) 725-6750

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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