Healthcare Provider Details

I. General information

NPI: 1801074240
Provider Name (Legal Business Name): RONALD L. BRITTNER DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 03/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 N BROADWAY SUITE 1100
PENNSVILLE NJ
08070-1253
US

IV. Provider business mailing address

390 N BROADWAY SUITE 1100
PENNSVILLE NJ
08070-1253
US

V. Phone/Fax

Practice location:
  • Phone: 856-678-6665
  • Fax: 856-678-7877
Mailing address:
  • Phone: 856-678-6665
  • Fax: 856-678-7877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number25MD00094200
License Number StateNJ

VIII. Authorized Official

Name: DR. RONALD L BRITTNER
Title or Position: PODIATRIST
Credential: DPM
Phone: 856-678-6665