Devita, Jack J
Devita, Jack J is an individual health care provider with primary practice located at 406 Lippincott Dr. Suite E, Marlton NJ 08053. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Devita, Jack J can be contacted via phone (856) 983-1900.Contact Information
Primary practice address
406 Lippincott Dr. Suite E
Marlton NJ 08053
Phone: (856) 983-1900
Fax: (856) 983-5110
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 25MA07219400 | New Jersey |
Profile Details
| NPI number | 1588624340 |
|---|---|
| LBN Legal business name | Devita, Jack J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Jan 19th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588624340 | NPPES |
| New Jersey | MEDICAID | 2371600 | |
| New Jersey | MEDICAID | 8523100 |
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