Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 25MA07800100 | NJ |
NPI | 1023119195 |
---|---|
Provider Name | Amy M Evangelisto |
First Address | Voorhees, NJ 08043-4509 |
Second Address | Voorhees, NJ 08043 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 16/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010006995 | AMERICHOICE (01) | NJ |
1661111 | AMERIHEALTH PPO PABS (01) | NJ |
2337004000 | AMERIHEALTH HMO (01) | NJ |
2428351 | UNITED HEALTCARE (01) | NJ |
3655581 | AETNA USHEALTHCARE (01) | NJ |
3K6155 | HEALTHNET, INC (01) | NJ |
40968 | UNIVERSITY HEALTH PLAN (01) | NJ |
8348415 | CIGNA (01) | NJ |
H24570 | (02) | |
P3556050 | OXFORD HEALTH PLAN (01) | NJ |