Basic Information
| Provider Information | |||||||||
| NPI: | 1831300243 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUFFY | ||||||||
| FirstName: | MEREDITH | ||||||||
| MiddleName: | CRISP | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 FEDERAL ST | ||||||||
| Address2: | STE SW200 | ||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8569687433 | ||||||||
| FaxNumber: | 8569688499 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 COOPER PLZ 400 HADDON AVE | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8556322667 | ||||||||
| FaxNumber: | 8563256643 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2007 | ||||||||
| LastUpdateDate: | 10/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0201X | MA08274000 | NJ | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology | 207VX0201X | ME90899 | FL | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology |
ID Information
| ID | Type | State | Issuer | Description | 2870429000 | 01 | NJ | AMERIHEALTH/KEYSTONE/IBC | OTHER | 60033608 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 0138843 | 05 | NJ | MEDICAID | 1607271/7895920 | 01 | NJ | AETNA | OTHER | 60036184 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 7180076 | 01 | NJ | CIGNA | OTHER | P3807795 | 01 | NJ | OXFORD | OTHER | 2802706 | 01 | NJ | UNITED HEALTHCARE | OTHER | 3K6564 | 01 | NJ | HEALTHNET | OTHER | 010048558 | 01 | NJ | AMERICHOICE | OTHER |