Charles L Dietzek, Do, Facos, Pc

LBN: Charles L Dietzek, Do, Facos, Pc
Charles L Dietzek, Do, Facos, Pc is an health care organization with primary practice located at 1000 White Horse Rd Suite 703, Voorhees NJ 08043-4406. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as the primary health care specialty. Charles L Dietzek, Do, Facos, Pc can be contacted via phone (856) 309-9777, or through Berkowitz, Susan via phone (856) 309-9777.

Contact Information

Primary practice address
1000 White Horse Rd Suite 703 Voorhees NJ 08043-4406
Fax: (856) 309-9774
Website:
Authorized official contact:
Name: Berkowitz, Susan

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X

Profile Details

NPI number 1306905658
LBN Legal business name Charles L Dietzek, Do, Facos, Pc
DBA Doing business as
Authorized official Berkowitz, Susan
Entity Organization
Organization subpart 1 No
Enumeration date Dec 6th, 2006
Last updated Feb 5th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306905658 NPPES
Other 3947376 AETNA
MEDICAID 0071641 AETNA
Other 60017604 AETNA

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