Provider Demographics
NPI:1124328869
Name:MULLICA HILL PODIATRY ASSOCIATES PA
Entity type:Organization
Organization Name:MULLICA HILL PODIATRY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-223-9939
Mailing Address - Street 1:53 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-9701
Mailing Address - Country:US
Mailing Address - Phone:856-223-9939
Mailing Address - Fax:
Practice Address - Street 1:53 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-9701
Practice Address - Country:US
Practice Address - Phone:856-223-9939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty