Organization Active NPI

Foda Family Practice LLC

  • Family Medicine Physician
  • Cherry Hill, NJ
National Provider Identifier
1508073016
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA07595300 Issued in NJ
Legal business name
FODA FAMILY PRACTICE LLC
Practice address
1939 Marlton Pike E Ste 250
Cherry Hill, NJ 08003-4507
Phone
(856) 985-9106
Fax
(609) 228-7604
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Authorized official

Name
Dr. Randa B Foda, MD
Title
Physcian
Phone
(856) 985-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 25MA07595300 NJ Primary

Addresses

Primary practice location

1939 Marlton Pike E Ste 250
Cherry Hill, NJ 08003-4507

Mailing address

1939 Marlton Pike E Ste 250
Cherry Hill, NJ 08003-4507
Phone (856) 985-9106

Other identifiers 1

IdentifierTypeStateIssuer
0023442MedicaidNJ

National Provider Directory

National Provider Directory

Locations

1939 Route 70 E
Ste 250
Cherry Hill, NJ 08003
Phone (609) 429-4433

2000 Academy Dr
Ste 600
Mount Laurel, NJ 08054
Phone (856) 985-9100

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1508073016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 MARLTON PIKE E STE 250",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080034507",
            "telephone_number": "856-985-9106",
            "fax_number": "609-228-7604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 MARLTON PIKE E STE 250",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080034507",
            "telephone_number": "856-985-9106",
            "fax_number": "609-228-7604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FODA FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "FODA",
        "authorized_official_first_name": "RANDA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSCIAN",
        "authorized_official_telephone_number": "856-985-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA07595300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0023442",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.