Depace, Nicholas L

Depace, Nicholas L is an individual health care provider with primary practice located at 438 Ganttown Rd Suites B8-B9, Sewell NJ 08080. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Nuclear Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Depace, Nicholas L can be contacted via phone (856) 589-6034.

Contact Information

Primary practice address
438 Ganttown Rd Suites B8-B9 Sewell NJ 08080
Phone: (856) 589-6034
Fax: (856) 589-6036
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 25MA03627300 New Jersey
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD023597E Pennsylvania
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD023597E Pennsylvania
Allopathic & Osteopathic Physicians / Nuclear Cardiology 207UN0901X 25MA03627300 New Jersey
Allopathic & Osteopathic Physicians / Nuclear Cardiology 207UN0901X MD023597E Pennsylvania
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 25MA03627300 New Jersey

Profile Details

NPI number 1467496687
LBN Legal business name Depace, Nicholas L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Jul 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467496687 NPPES
New Jersey Other 0229598000 KEYSTONE HEALTH PLAN EAST
New Jersey Other 1048118 KEYSTONE HEALTH PLAN EAST
New Jersey Other 4100717 KEYSTONE HEALTH PLAN EAST
New Jersey Other 530072 KEYSTONE HEALTH PLAN EAST
New Jersey Other P3785506 KEYSTONE HEALTH PLAN EAST
New Jersey Other 0229598000 KEYSTONE HEALTH PLAN EAST
New Jersey MEDICAID 5264103 KEYSTONE HEALTH PLAN EAST
New Jersey Other 01004610300 KEYSTONE HEALTH PLAN EAST
New Jersey Other 0229598000 KEYSTONE HEALTH PLAN EAST
New Jersey Other 0154010 KEYSTONE HEALTH PLAN EAST

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