MEDICARE: DR. KRISTEN E RADCLIFF MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XS0117X	Orthopaedic Surgery of the Spine Physician	MD437115	PA
2	207XS0117X	Orthopaedic Surgery of the Spine Physician	308177	NY
3	207XS0117X	Orthopaedic Surgery of the Spine Physician	25MA08665500	NJ

General Provider Information

NPI Number	:	1003071010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTEN E RADCLIFF MD

Provider Business Mailing Address
First Line	:	415 NEW RD STE 3
Second Line	:
City	:	SOMERS POINT
State	:	NJ
Zip	:	08244-2106
Country	:	US
Telephone Number	:	609-800-3472
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 NEW RD STE 3
Second Line	:
City	:	SOMERS POINT
State	:	NJ
Zip	:	08244-2106
Country	:	US
Telephone Number	:	609-800-3472
Fax Number	:	609-842-4040

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2008
Last Update Date	:	03/17/2026

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