1538241682 NPI number — W REED KINDERMANN, M.D. P.A.

Table of content: (NPI 1538241682)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538241682 NPI number — W REED KINDERMANN, M.D. P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
W REED KINDERMANN, M.D. P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538241682
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/06/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3001 CHAPEL AVE W
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
CHERRY HILL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08002-1592
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-667-3937
Provider Business Mailing Address Fax Number:
856-667-0661

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3001 CHAPEL AVE W
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
CHERRY HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08002-1592
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-667-3937
Provider Business Practice Location Address Fax Number:
856-667-0661
Provider Enumeration Date:
10/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KINDERMANN
Authorized Official First Name:
W
Authorized Official Middle Name:
REED
Authorized Official Title or Position:
PRINCIPAL
Authorized Official Telephone Number:
856-667-3937

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  25MA03484500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DG1437 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3900703 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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