Healthcare Provider Details
I. General information
NPI: 1255344594
Provider Name (Legal Business Name): ARTHRITIS & RHEUMATOLOGY ASSOCIATES OF SOUTH JERSEY PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/15/2006
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2848 S DELSEA DR SUITE 2C
VINELAND NJ
08360
US
IV. Provider business mailing address
P.O. BOX 2697
VINELAND NJ
08362-2697
US
V. Phone/Fax
- Phone: 856-794-9090
- Fax: 856-794-5658
- Phone: 856-794-9090
- Fax: 856-794-5658
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | 25MA05934500 |
| License Number State | NJ |
VIII. Authorized Official
Name:
STEPHEN
SOLOWAY
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 856-794-1003