Basic Information
| Provider Information | |||||||||
| NPI: | 1477578011 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAMISHION | ||||||||
| FirstName: | GERMAINE | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CAMISHION | ||||||||
| OtherFirstName: | GERMAINE | ||||||||
| OtherMiddleName: | M | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 702 EAST MAIN STREET | ||||||||
| Address2: | TRIANGLE MEDICAL ARTS BLDG | ||||||||
| City: | MOORESTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8562356565 | ||||||||
| FaxNumber: | 8562356566 | ||||||||
| Practice Location | |||||||||
| Address1: | 702 E MAIN ST | ||||||||
| Address2: | TRIANGLE MEDICAL ARTS BLDG | ||||||||
| City: | MOORESTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080573079 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8562356565 | ||||||||
| FaxNumber: | 8562356566 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2006 | ||||||||
| LastUpdateDate: | 09/09/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | MA54599 | NJ | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.