Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Edwin J Custodio, APN

Individual provider Family Nurse Practitioner · NPI 1174318844

Edwin J Custodio, APN is a Nurse Practitioner in Hammonton, New Jersey. Qualified in 2025, 1 year ago. Practices with Southern Jersey Family Medical Centers, Inc, a 36-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
1
Licensed in
NJ
In the registry since
2025
What do these letters mean?
APN — Advanced Practice Nurse
The umbrella title some states use for nurse practitioners and other advanced practice nurses.

See every abbreviation used in this directory →

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Practice location Address checks out

860 S White Horse Pike
Hammonton, NJ 08037-2018
Phone: (609) 567-0200
Fax: (609) 567-1951
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 26NJ15527500 (NJ)

Record details

NPI number1174318844
Entity typeIndividual (Type 1)
GenderMale
Credentials APN
Sole proprietorYes
NPI enumeratedApril 11, 2025
Last updated in NPPESApril 28, 2026
Certification dateApril 28, 2026
Mailing address521 Richard Dr, Millville, NJ 08332-4040

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Southern Jersey Family Medical Centers, Inc — 36 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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