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General NPI Number Information
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NPI Number | 1598170417
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Entity Type | Organization
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Legal Business Name | STEM CELL AND REGENERATIVE MEDICINE INSTITUTE
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Dates
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Enumeration Date | 06/30/2014
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Last Update Date | 06/30/2014
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Provider Practice Location Address
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Address Line | 2007 N BLACK HORSE PIKE
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-9120
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Country | US
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Telephone | 856-296-9616
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Fax |
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Provider Business Mailing Address
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Address Line | 2007 N BLACK HORSE PIKE
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-9120
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Country | US
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Telephone | 856-296-9616
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | CHARLES NICHOLAS KROME
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Credential | D.O.
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Telephone | 856-797-2879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 25MB07964500
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License Number State | NJ
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