Healthcare Provider Details

I. General information

NPI: 1255369369
Provider Name (Legal Business Name): LANCE WILLIAM NEVELING D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 ATLANTIC AVE
COLLINGSWOOD NJ
08108-3042
US

IV. Provider business mailing address

250 WAYNE AVE
HADDONFIELD NJ
08033-1464
US

V. Phone/Fax

Practice location:
  • Phone: 856-854-1050
  • Fax: 856-854-5325
Mailing address:
  • Phone: 856-795-1867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB069685
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: