Unknown Individual – Family Medicine Physician, NPI 1063448603
Family Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
401 ROUTE 73 N
40 LAKE CENTER DRIVE SUITE 201A
MARLTON, NJ 080533425
Phone: (856) 355-0340
Fax: (856) 355-0346
Type: Mailing
State Route 38, Hollybrook, Lumberton Township, Burlington County, New Jersey, 08048, United States
LUMBERTON, NJ 080482921
Phone: (609) 261-3716
Fax: (609) 261-5507
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $60.
Total Amount is formed as General ($60) + Research ($0) + Ownership ($0) = $60.
Last reported payment date: 2024-11-04 • Largest payer in this snapshot: Astellas Pharma US Inc ($42).
Total Amount
$60
General + Research + Ownership
Payments
3
Total payment records
General Amount
$60
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Astellas Pharma US Inc | $42 |
| PFIZER INC. | $18 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 08053)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NJ | |
| Advanced Heart Failure And Transplant Cardiology | MD | |
| - | NJ | |
| - | NJ | |
| G A S T R O E N T E R O L O G Y | NJ | |
| - | NJ | |
| Nurse Practitioner | NJ | |
| Nurse Practitioner | NJ | |
| - | NJ | |
| - | NJ |
Reviews
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