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Individual

DR. LOUIS JOHN CIRAVOLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
602 S BROADWAY, CAMDEN, NJ 08103-1222
(856) 963-2266
(856) 772-2881
Mailing address
1021 OAKLYN CT, VOORHEES, NJ 08043-1817
(856) 772-2885
(856) 772-2881

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
MD02339
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010002883-00
AMERICHOICE OF NJ
NJ
01
1107086
HORIZON NJ HEALTH
NJ
05
7279302
NJ
Enumeration date
01/05/2007
Last updated
07/09/2007
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