Provider Demographics
NPI:1548364177
Name:FAMILY PRACTICE ASSOCIATES AT WASHINGTON PA
Entity type:Organization
Organization Name:FAMILY PRACTICE ASSOCIATES AT WASHINGTON PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:VENUTI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:856-875-8000
Mailing Address - Street 1:188 FRIES MILL RD
Mailing Address - Street 2:SUITE N-3
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2015
Mailing Address - Country:US
Mailing Address - Phone:856-875-8000
Mailing Address - Fax:856-875-8494
Practice Address - Street 1:188 FRIES MILL RD
Practice Address - Street 2:STE N-3
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2015
Practice Address - Country:US
Practice Address - Phone:856-875-8000
Practice Address - Fax:856-875-8494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ541472Medicare PIN