Individual
DR. WILLIAM L NIEDRACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11 ROXBURY DR, MEDFORD, NJ 08055-3202
(609) 304-4337
Mailing address
11 ROXBURY DR, MEDFORD, NJ 08055-3202
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
25MA05931400
NJ
208800000X
Urology Physician
Primary
MD479949
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0465067
AETNA
—
01
—
0654743000
AMERIHEALTH
—
Enumeration date
01/30/2006
Last updated
02/01/2023
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