Requa, Eric Robert

Requa, Eric Robert is an individual health care provider with primary practice located at 1001 Route 73 N Lowr Level , Marlton NJ 08053-4524. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Requa, Eric Robert can be contacted via phone (844) 908-5483.

Contact Information

Primary practice address
1001 Route 73 N Lowr Level Marlton NJ 08053-4524
Phone: (844) 908-5483
Fax: (856) 355-7106
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS017463 Pennsylvania
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 25MB09913200 New Jersey

Profile Details

NPI number 1164788501
LBN Legal business name Requa, Eric Robert
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2012
Last updated Oct 15th, 2020 - about 5 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 1164788501 NPPES
Pennsylvania MEDICAID 103025113
Pennsylvania MEDICAID 103056183

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