NPIMap

Organization Active NPI

Professional Service Fund of Deborah Heart & Lung Center

  • Specialist
  • Browns Mills, NJ
National Provider Identifier
1407803596
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PROFESSIONAL SERVICE FUND OF DEBORAH HEART & LUNG CENTER
Practice address
200 Trenton Rd
Browns Mills, NJ 08015-1705
Phone
(609) 893-1200
Fax
(609) 735-0175
NPI assigned
May 27, 2006
Last updated
Apr 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Joseph Chirichella
Title
Chief Executive Officer
Phone
(609) 893-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

200 Trenton Rd
Browns Mills, NJ 08015-1705

Mailing address

200 Trenton Rd
Browns Mills, NJ 08015-1705
Phone (609) 893-1200

Other identifiers 1

IdentifierTypeStateIssuer
3500306MedicaidNJ

Other names 1

  • Professional Service Fund of Deborah Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040127000717 NJ Part B Supplier - Clinic/Group Practice 4284537499 Receives reassigned benefits from 236 practitioners
Practice locations: Browns Mills, NJ

National Provider Directory

National Provider Directory

Locations

6 Earlin Ave
Browns Mills, NJ 08015
Phone (609) 735-2961

1445 Whitehorse Mercerville Rd
Ste 109
Mercerville, NJ 08619
Phone (609) 393-1524

Practitioners & affiliated clinicians

Practitioners 304

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 304

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333411200000",
    "number": "1407803596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TRENTON RD",
            "city": "BROWNS MILLS",
            "state": "NJ",
            "postal_code": "080151705",
            "telephone_number": "609-893-1200",
            "fax_number": "609-735-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TRENTON RD",
            "city": "BROWNS MILLS",
            "state": "NJ",
            "postal_code": "080151705",
            "telephone_number": "609-893-1200",
            "fax_number": "609-735-0175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL SERVICE FUND OF DEBORAH HEART & LUNG CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2012-04-03",
        "status": "A",
        "authorized_official_last_name": "CHIRICHELLA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "609-893-1200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3500306",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Service Fund of Deborah",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Browns Mills, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.