Provider Demographics
NPI:1164213591
Name:FAMILY TREE MEDICAL SOLUTIONS
Entity type:Organization
Organization Name:FAMILY TREE MEDICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GWENETTA
Authorized Official - Middle Name:REMONA
Authorized Official - Last Name:TOWNSEL
Authorized Official - Suffix:
Authorized Official - Credentials:ARPN
Authorized Official - Phone:609-674-2003
Mailing Address - Street 1:1005 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08232-1125
Mailing Address - Country:US
Mailing Address - Phone:609-674-2003
Mailing Address - Fax:
Practice Address - Street 1:38 HIGHLAND CIR
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-6626
Practice Address - Country:US
Practice Address - Phone:609-674-2003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty