Healthcare Provider Details

I. General information

NPI: 1821406802
Provider Name (Legal Business Name): KROME'S REGENERATIVE MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 07/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2007 N BLACK HORSE PIKE
WILLIAMSTOWN NJ
08094-9120
US

IV. Provider business mailing address

2007 N BLACK HORSE PIKE
WILLIAMSTOWN NJ
08094-9120
US

V. Phone/Fax

Practice location:
  • Phone: 856-740-4888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: AMY SMITH
Title or Position: BILLING MANAGER
Credential:
Phone: 856-797-2879