Organization
ROWANSOM DEPT OF PULMONARY MEDICINE
Active
Organization
ROWANSOM DEPT OF PULMONARY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RIEKER (INTERIM CHIEF FINANCIAL OFFICER)
(856) 770-5729
Entity
Organization
Contact information
Practice address
42 E LAUREL RD, SUITE 3100, STRATFORD, NJ 08084-1354
(856) 566-6859
(856) 566-6952
Mailing address
42 E LAUREL RD, SUITE 3100, STRATFORD, NJ 08084-1354
(856) 566-6859
(856) 566-6952
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033918
MEDICARE ID
NJ
01
—
2453475000
AMERIHEALTH
—
05
—
3152405
—
NJ
01
—
33211
AETNA
NJ
01
—
CD2384
RR MEDICARE
NJ
Enumeration date
01/24/2006
Last updated
05/03/2013
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