Basic Information
Provider Information
NPI: 1215161856
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAW
FirstName: HENRY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 700 ROUTE 130 N
Address2: SUITE 203
City: CINNAMINSON
State: NJ
PostalCode: 080773365
CountryCode: US
TelephoneNumber: 8568299345
FaxNumber:  
Practice Location
Address1: 435 HURFFVILLE CROSS KEYS RD
Address2:  
City: TURNERSVILLE
State: NJ
PostalCode: 080122453
CountryCode: US
TelephoneNumber: 8568299345
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/12/2009
LastUpdateDate: 07/08/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X25MB09235400NJY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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