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General NPI Number Information
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NPI Number | 1487666889
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Entity Type | Organization
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Legal Business Name | SOUTH JERSEY PULMONARY ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 310 WOODSTOWN RD
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City | SALEM
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State | NJ
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Zip | 08079-2064
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Country | US
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Telephone | 856-935-0276
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Fax | 856-935-1638
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Provider Business Mailing Address
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Address Line | 310 WOODSTOWN RD
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City | SALEM
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State | NJ
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Zip | 08079-2064
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Country | US
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Telephone | 856-935-0276
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Fax | 856-935-1638
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | ROMAN KROL
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Credential | MD
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Telephone | 865-935-0276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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