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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