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CENTER FOR ADULT MEDICINE OF SNJ PA
NPI 1407007578
Specialist in Marlton, NJ

Active since October 07, 2008CLIA 31D0996699 · Waiver
12000 LINCOLN DR WEST, 405, PAVILIONS @ GREENTREE, MARLTON, NJ 08053(856) 985-0203(856) 985-0010 Get Directions Write a Review

NPPES record last updated: February 16, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Center For Adult Medicine Of Snj Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTER FOR ADULT MEDICINE OF SNJ PA (NPI 1407007578) is a healthcare organization registered as a specialist in Marlton, New Jersey and active in the NPI registry since October 2008. The organization holds a CLIA Waiver certificate valid through February 24, 2028 and lists Shahin Michael Mirmanesh, Physician, as its authorized official.

NPPES Registry Identity

NPI1407007578
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameCENTER FOR ADULT MEDICINE OF SNJ PA
Location Address12000 LINCOLN DR WEST, 405, PAVILIONS @ GREENTREEMarlton, NJ 08053
Mailing AddressP.o. Box 3714Cherry Hill, NJ 08034 · (856) 985-0203 · Fax (856) 985-0010
Phone(856) 985-0203
Fax(856) 985-0010
Organization SubpartNo
Authorized OfficialShahin Michael MirmaneshPhysician · (856) 985-0203
Enumeration DateOctober 7, 2008
Last NPPES UpdateFebruary 16, 2016
✔ NPI 1407007578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NJ · 25MA06992000
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
12000 LINCOLN DR WEST, Marlton, NJ 08053
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Other Identifiers 2

Medicare UPINH03441NJ
Medicare PIN031442NJ

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D0996699

Center For Adult Medicine Of Snj PA · Marlton, NJ
Active · expires Feb 24, 2028
CLIA Number31D0996699
Laboratory TypePhysician Office
Certificate Effective DateFebruary 25, 2026
Certificate Expiration DateFebruary 24, 2028
Laboratory DirectorS Michael Mirmanesh
Laboratory Phone(856) 985-8100
Laboratory LocationCenter For Adult Medicine Of Snj PA651 Rte 73 N Ste 405 The Pavillions At Greentree, Marlton, NJ 08053
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Center For Adult Medicine Of Snj PA's NPI number?

The NPI number for Center For Adult Medicine Of Snj PA is 1407007578. It was assigned to this organization in the NPPES registry on October 7, 2008.

Where is Center For Adult Medicine Of Snj PA located?

Center For Adult Medicine Of Snj PA is located at 12000 Lincoln Dr West 405, Pavilions @ Greentree, Marlton, NJ 08053. The listed phone number is (856) 985-0203.

What is Center For Adult Medicine Of Snj PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Center For Adult Medicine Of Snj PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D0996699) is associated with this NPI, valid through February 24, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Center For Adult Medicine Of Snj PA was last updated on February 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.