Excelsia NJ, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

EXCELSIA NJ, LLC

Practice address

1937 Berlin Rd
Cherry Hill, NJ 08003-3737

Phone

(856) 616-0610

NPI assigned

Jan 18, 2024

Organization subpart

No

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

Authorized official

Name

John Wall, J.D.

Title

Chief Legal Officer

Phone

(412) 496-9559

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1912768847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 PULASKI PARK DR STE 417",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212201409",
            "telephone_number": "410-933-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1937 BERLIN RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080033737",
            "telephone_number": "856-616-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIA NJ, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "412-496-9559",
        "authorized_official_credential": "J.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Multi-Specialty Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.