TARA L. WYCHE-BULLOCK (NPI# 1720008931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720008931 |
| Entity Type | Individual |
| Full Name | TARA L. WYCHE-BULLOCK |
| Credential | M.D. |
| Practice Address |
155 Bridgeton Pike Mullica Hill NJ 08062-2669 |
| Practice Telephone | 8562230500 |
| Practice Fax Number | 8562231098 |
| Mailing Telephone | 8562230500 |
| Mailing Fax Number | 8562231098 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2012-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 25MA07694800 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | CIGNA | 2030554 | 01 |
| NJ | AMERIGROUP | 304846 | 01 |
| Street Address |
155 BRIDGETON PIKE |
| City | MULLICA HILL |
| State | NJ |
| Zip Code | 08062-2669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992781298 | Maria C Kent | Family Medicine | 155 Bridgeton Pike, Suite A, Mullica Hill, NJ 08062-2669 | 2005-12-19 |
| 1619272770 | Underwood-memorial Hospital | Surgery | 155 Bridgeton Pike, Mullica Hill, NJ 08062-2669 | 2011-01-21 |
| 1679639496 | Anna Jang Hanson | Obstetrics & Gynecology | 155 Bridgeton Pike, Suite C, Mullica Hill, NJ 08062-2669 | 2006-12-28 |
| 1962434274 | Vivian Vega | Obstetrics & Gynecology | 155 Bridgeton Pike, Ste C, Mullica Hill, NJ 08062-2669 | 2006-07-07 |
| 1851323141 | Jeffrey T Gibson | Obstetrics & Gynecology | 155 Bridgeton Pike, Suite C, Mullica Hill, NJ 08062-2669 | 2006-07-07 |
| 1992737209 | Joann M Casella | Nurse Practitioner | 155 Bridgeton Pike, Ste C, Mullica Hill, NJ 08062-2669 | 2006-07-07 |
| 1609808914 | Karen Norton | Nurse Practitioner | 155 Bridgeton Pike, Suite C, Mullica Hill, NJ 08062-2669 | 2006-07-07 |
| 1548290695 | Byron Hapner | Obstetrics & Gynecology | 155 Bridgeton Pike, Suite C, Mullica Hill, NJ 08062-2669 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881254308 | Kaplan & Tyson, LLC Dba Eye Associates | Durable Medical Equipment & Medical Supplies | 5 Myers Drive, Suite 101, Mullica Hill, NJ 08062 | 2019-06-17 |
| 1588165526 | Mullica Hill Family Dental, LLC | Dentist | 7 Myers Drive Unit A, Mullica Hill, NJ 08062 | 2018-02-26 |
| 1639689102 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 116 Iredell Lane, Mullica Hill, NJ 08062 | 2017-10-10 |
| 1639697782 | Kingsway Recovery LLC | Counselor | 124 Bridgeton Pike, Mullica Hill, NJ 08062 | 2017-09-08 |
| 1568998912 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 484 Fislerville Rd (richwood), Mullica Hill, NJ 08062 | 2017-05-04 |
| 1114381399 | Advoserv of New Jersey, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 444 Fislerville Rd, South Harrison Twp, NJ 08062 | 2016-04-13 |
| 1053687574 | New Jersey Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 524 Mullica Hill Rd, Harrison Township, NJ 08062 | 2012-03-29 |
| 1134491590 | South Jersey Healthcare | Clinic/Center | 210 Tomlin Station Road, Mullica Hill, NJ 08062 | 2012-02-01 |
| 1144592502 | South Jersey Healthcare | Clinic/Center | 201 Tomlin Station Park Suite D, Mullica Hill, NJ 08062 | 2012-02-01 |
| 1760764898 | Inspira Medical Centers, Inc. | Clinic/Center | 201 Tomlin Station Road, Suite A, Mullica Hill, NJ 08062 | 2011-09-14 |
| Find all providers in zip 08062 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184162133 | Wellbox Nj PC | Family Medicine | 107 Lafayette Dr, Mullica Hill, NJ 08062-4542 | 2017-02-09 |
| 1205279189 | G & M Consulting Services Inc. | Family Medicine | 13 Winding Way, Mullica Hill, NJ 08062-2511 | 2013-04-10 |
| 1972619591 | Maria Cristina Zuazua-pacilio | Family Medicine | 155 Bridgeton Pike Ste A, Mullica Hill, NJ 08062-2669 | 2006-08-23 |
| 1124058367 | Claudine De Dan | Family Medicine | 34 Colson Ln Ste B, Mullica Hill, NJ 08062-1502 | 2006-07-04 |
| 1124072285 | Craig M. Wax | Family Medicine | 155 N Main St, Mullica Hill, NJ 08062-2612 | 2006-05-20 |
| 1992781298 | Maria C Kent | Family Medicine | 155 Bridgeton Pike, Suite A, Mullica Hill, NJ 08062-2669 | 2005-12-19 |
| 1649267881 | Gregory G Stiefel | Family Medicine | 201 Tomlin Station Rd, Ste B, Mullica Hill, NJ 08062-1612 | 2005-10-03 |
| 1134646268 | Claudine M De Dan Md LLC | Family Medicine | 34 Colson Ln Ste B, Mullica Hill, NJ 08062-1502 | 2017-08-29 |
| 1669993754 | Daisy Andreina Amato | Family Medicine | 201 Tomlin Station Rd, Mullica Hill, NJ 08062-1612 | 2017-06-29 |
| 1164858700 | Kristen Elizabeth Trom | Family Medicine | 155 Bridgeton Pike Ste A, Mullica Hill, NJ 08062-2669 | 2013-09-15 |
| Find all providers in MULLICA HILL | ||||
| City | MULLICA HILL |
| Zip Code | 08062 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.