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General NPI Number Information
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NPI Number | 1982613113
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Entity Type | Organization
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Legal Business Name | REGIONAL NEPHROLOGY ASSOCIATES, P.A.
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 510 JACKSON AVE
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City | NORTHFIELD
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State | NJ
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Zip | 08225
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Country | US
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Telephone | 609-383-0200
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Fax | 609-383-8352
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Provider Business Mailing Address
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Address Line | 510 JACKSON AVE
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City | NORTHFIELD
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State | NJ
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Zip | 08225
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Country | US
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Telephone | 609-383-0200
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Fax | 609-383-8352
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Authorized Official
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Title or Position | SECRETARY
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Name | RAYMOND S SCHREYER
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Credential | MD
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Telephone | 609-383-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State | NJ
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