Healthcare Provider Details

I. General information

NPI: 1073623088
Provider Name (Legal Business Name): RONALD ANTHONY BARBELLA JR. DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RONALD ANTHONY BARBELLA DPM

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 NORTH MAPLE AVENUE SUITE G2
MARLTON NJ
08053-2210
US

IV. Provider business mailing address

230 NORTH MAPLE AVENUE SUITE G2
MARLTON NJ
08053-2210
US

V. Phone/Fax

Practice location:
  • Phone: 856-220-6526
  • Fax: 856-235-3105
Mailing address:
  • Phone: 856-220-6526
  • Fax: 856-235-3105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00234500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number25MD000234500
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number25MD00234500
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number25MD00234500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: