Individual
DR. KEVIN MEEHAN ROENBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
85 S MAPLE AVE, RIDGEWOOD, NJ 07450-4561
(201) 445-2830
(201) 445-7471
Mailing address
85 S MAPLE AVE, RIDGEWOOD, NJ 07450-4561
(201) 445-2830
(201) 445-7471
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
25MA08094600
NJ
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
25MA08094600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
802006WXN
MEDICARE NUMBER
NJ
Enumeration date
05/24/2008
Last updated
04/26/2019
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