Hydration Clinics of America

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MB05610900 Issued in NJ

Legal business name

HYDRATION CLINICS OF AMERICA

Practice address

538 Lippincott Dr
BLG E
Marlton, NJ 08053-4806

Phone

(856) 489-0555

Fax

(856) 489-0505

NPI assigned

Dec 27, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Amalia Fantasia, PHD

Title

Adminstor

Phone

(856) 489-0555

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1482796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1477098663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 LIPPINCOTT DR",
            "address_2": "BLG E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534806",
            "telephone_number": "856-489-0555",
            "fax_number": "856-489-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 LIPPINCOTT DR",
            "address_2": "BLG E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534806",
            "telephone_number": "856-489-0555",
            "fax_number": "856-489-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDRATION CLINICS OF AMERICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-27",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "FANTASIA",
        "authorized_official_first_name": "AMALIA",
        "authorized_official_title_or_position": "ADMINSTOR",
        "authorized_official_telephone_number": "856-489-0555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB05610900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "12352000775",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Helena Husfelt
• Whitney Leigh Huston, DO
• Rachel Hutnick, MA, LPC
• David Bryan Huttinger, PT
• Richard James Huynh
• I. Harvey Getzoff, PA
• Madison Caroline Iannotta
• Kennedy M Ilagan, PT/DPT
• Kiersten Ilaoa
• Heather Lisa Ilconich, LCSW

• Family Medicine Physician in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.