Provider Demographics
NPI:1699703587
Name:FAMILY PRACTICE ASSOCIATES OF CUMBERLAND CO PC
Entity type:Organization
Organization Name:FAMILY PRACTICE ASSOCIATES OF CUMBERLAND CO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:BEAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-451-9595
Mailing Address - Street 1:230 LAUREL HEIGHTS DRIVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-3634
Mailing Address - Country:US
Mailing Address - Phone:856-451-9595
Mailing Address - Fax:856-451-4130
Practice Address - Street 1:230 LAUREL HEIGHTS DRIVE
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-3634
Practice Address - Country:US
Practice Address - Phone:856-451-9595
Practice Address - Fax:856-451-4130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty