Dr. Eric Robert Requa
Family Doctor Family Doctor - Sports Medicine
1001 Route 73 N Lowr Level
Marlton
, New Jersey 08053-4524
Dr. Eric Robert Requa
Family Doctor Family Doctor - Sports Medicine
1001 Route 73 N Lowr Level
Marlton
, New Jersey 08053-4524
(856) 355-0330
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About
Features
Specialties
- Family Doctor
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Eric Robert Requa
- 2000 Crawford Pl Ste 200
- Mount Laurel, NJ
- Zip : 08054-3954
- Fax : (856) 355-0330
- Phone : (856) 355-0340
Second Address
- Dr. Eric Robert Requa
- 1001 Route 73 N Lowr Level
- Marlton, NJ
- Zip : 08053-4524
- Fax : (856) 355-7106
- Phone : (844) 908-5483
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FAQs
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Is Dr. Eric Robert Requa a sole practitioner?
Is Dr. Eric Robert Requa accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Q00000X | Family Doctor | OS017463 | PA |
| Y | 207QS0010X | Family Doctor - Sports Medicine | 25MB09913200 | NJ |
National Provider Identifier
| NPI | 1164788501 |
|---|---|
| Provider Name | Dr. Eric Robert Requa |
| First Address | Mount Laurel, NJ 08054-3954 |
| Second Address | Marlton, NJ 08053-4524 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/04/2012 |
| Last Update Date | 15/10/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 103025113 | (05) | PA |
| 103056183 | (05) | PA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.