Provider Demographics
NPI:1386724557
Name:FAMILY PRACTICE ASSOCIATES OF VOORHEES, PA
Entity type:Organization
Organization Name:FAMILY PRACTICE ASSOCIATES OF VOORHEES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MARZILI
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:856-751-1777
Mailing Address - Street 1:805 COOPER RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-3814
Mailing Address - Country:US
Mailing Address - Phone:856-751-8090
Mailing Address - Fax:
Practice Address - Street 1:805 COOPER RD
Practice Address - Street 2:SUITE 3
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-3814
Practice Address - Country:US
Practice Address - Phone:856-751-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5520304Medicaid
NJ5520304Medicaid
NJH25409Medicare UPIN
NJF51851Medicare UPIN
NJF53486Medicare UPIN