Individual
DR. KWAN THANAPORN RIVLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 BOWMAN DR STE E385, VOORHEES, NJ 08043-9638
(856) 840-4534
Mailing address
200 BOWMAN DRIVE, SUITEE385, MOORESTOWN, NJ 08043
(856) 840-4534
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
255025
MA
207R00000X
Internal Medicine Physician
Primary
25MA09669000
NJ
208M00000X
Hospitalist Physician
25MA09669000
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0569321
—
NJ
Enumeration date
01/29/2013
Last updated
04/17/2025
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