Most Relevant Information
Provider Data
| NPI Number: | 1003563636 |
| Provider Name: | PHENITA SAMMANTHA MOUZON |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 26NJ01281000 |
Most Important Dates
| Enumeration Date: | 03/03/2022 |
| Last Updated: | 08/15/2023 |
Provider Practice Location
777 ROUTE 70 E STE G101
MARLTON
NJ
080532548
Practice Location Phone/Fax
| Phone: | 8568184020 |
| Fax: |
Provider Mailing Location
68 WOODHAVEN RD
TOMS RIVER
NJ
087532062
Provider Mailing Phone/Fax
| Phone: | 7329987191 |
| Fax: |