Dr. Audrey Jane Iacobucci, MD
Pediatrics in Blackwood, NJ. Individual provider (NPI-1).
NPI number1154589869
StatusActive
Last updated in NPPESMay 26, 2011
Details
- NPI
- 1154589869
- Entity type
- Individual (NPI-1)
- Name
- Dr. Audrey Jane Iacobucci
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 29, 2008
- Last updated
- May 26, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | 25MA08469700 | NJ | Yes |
Practice location
527 S Black Horse PikeBlackwood, NJ 08012-2868
Phone 856-228-1061 · Fax 856-228-1907
Mailing address
402 Lippincott DrMarlton, NJ 08053-4112
Phone 856-782-3300 · Fax 856-504-8029
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