Organization
ROWANSOM DEPT OF GASTROENTEROLOGY
Active
Organization
ROWANSOM DEPT OF GASTROENTEROLOGY
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 3500, STRATFORD, NJ 08084-1354
(856) 566-6853
(856) 566-7002
Mailing address
42 E LAUREL RD, SUITE 3500, STRATFORD, NJ 08084-1354
(856) 566-6853
(856) 566-7002
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0072924000
AMERIHEALTH
NJ
05
—
3152600
—
NJ
01
—
33183
AETNA
NJ
01
—
CA1490
RR MEDICARE
NJ
Enumeration date
02/15/2006
Last updated
05/03/2013
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