Healthcare Provider Details

I. General information

NPI: 1386626760
Provider Name (Legal Business Name): JOSEPH W. KROTEC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8002 GREENTREE COMMONS
MARLTON NJ
08053-3209
US

IV. Provider business mailing address

8002 GREENTREE COMMONS
MARLTON NJ
08053-3209
US

V. Phone/Fax

Practice location:
  • Phone: 856-751-5575
  • Fax: 856-751-7289
Mailing address:
  • Phone: 856-751-5575
  • Fax: 856-751-7289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD019488E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: