Organization
ROWANSOM DEPT OF OBSTETRICS GYNECOLOGY
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 2500, STRATFORD, NJ 08084-1354
(856) 566-7090
(856) 566-6026
Mailing address
42 E LAUREL RD, SUITE 2500, STRATFORD, NJ 08084-1354
(856) 566-7090
(856) 566-6026
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0220686000
AMERIHEALTH
NJ
01
—
2402381000
AMERIHEALTH-MED LEVEL
NJ
01
—
30898
AETNA
NJ
05
—
3159400
—
NJ
01
—
CA4092
RR MEDICARE
NJ
Enumeration date
01/23/2006
Last updated
05/03/2013
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