Healthcare Provider Details

I. General information

NPI: 1366421489
Provider Name (Legal Business Name): HORACE L RAMDIAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 07/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HADDON AVE
CAMDEN NJ
08103-3101
US

IV. Provider business mailing address

500 GROVE ST SUITE 100
HADDON HEIGHTS NJ
08035-1761
US

V. Phone/Fax

Practice location:
  • Phone: 856-757-3500
  • Fax:
Mailing address:
  • Phone: 856-796-9255
  • Fax: 856-796-9397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number25MA06067900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMA06067900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: