Healthcare Provider Details

I. General information

NPI: 1003983594
Provider Name (Legal Business Name): RICHARD A KADER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 10/19/2020
Certification Date: 10/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NEW RD STE 150A
LINWOOD NJ
08221-1100
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 120
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 609-788-3338
  • Fax: 609-788-3348
Mailing address:
  • Phone: 856-355-0335
  • Fax: 856-355-0354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB05376200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: