Organization
SOUTH JERSEY SPORTS & SPINE MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERYL Y STEIN MD (OWNER)
(856) 874-9777
Entity
Organization
Contact information
Practice address
525 ROUTE 73 SOUTH, EVESHAM COMMONS- SUITE 104A, MARLTON, NJ 08053-9643
(856) 874-9777
(856) 874-9444
Mailing address
PO BOX 22462, PHILADELPHIA, PA 19110-2462
(215) 732-7600
(856) 874-9444
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0075728
—
NJ
01
—
2625614000
AMERIHEALTH
NJ
01
—
610782200
DEPARTMENT OF LABOR
NJ
Enumeration date
07/25/2006
Last updated
10/25/2010
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