| Dr Eric W Bantz, MD | |
|
103 Old Marlton Pike Ste 211, Medford, NJ 08055-8772 | |
| (609) 953-7500 | |
| (609) 953-9085 |
| Full Name | Dr Eric W Bantz |
|---|---|
| Gender | Male |
| Speciality | Allergy & Immunology - Allergy |
| Location | 103 Old Marlton Pike Ste 211, Medford, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124172598 | NPI | - | NPPES |
| 0811426 | Other | NJ | CIGNA PROVIDER # |
| P381888 | Other | NJ | OXFORD PROVIDER ID |
| 147995 | Other | NJ | KEYSTONE INSURANCE ID |
| 5312302 | Medicaid | NJ | |
| 010003124010 | Medicaid | NJ | |
| 3373326 | Other | NJ | AETNA PROVIDER ID |
| 721570737 | Other | NJ | TAX ID# |
| 83386 | Medicaid | NJ | |
| J017341 | Other | NJ | TRICARE PRIME PROVIDER ID |
| 0350808000 | Other | NJ | AMERIHEALTH HMO PROVIDER |
| 60012703 | Other | NJ | HORIZON-MERCY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207KA0200X | Allergy & Immunology - Allergy | MA48238 (New Jersey) | Primary |
| Entity Name | Regional Otolaryngology Head And Neck Associates, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679528426 PECOS PAC ID: 9739162637 Enrollment ID: O20040611000013 |
| Entity Name | Cornerstone Asthma And Allergy Associates, L.l.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750470761 PECOS PAC ID: 8820052947 Enrollment ID: O20041117000896 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Eric W Bantz, MD 103 Old Marlton Pike Ste 211, Medford, NJ 08055-8772 Ph: (609) 953-7500 | Dr Eric W Bantz, MD 103 Old Marlton Pike Ste 211, Medford, NJ 08055-8772 Ph: (609) 953-7500 |
Dr. Maaz Jalil, D.O. Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 103 Old Marlton Pike, Suite 211, Medford, NJ 08055 Phone: 856-576-5742 Fax: 856-519-5457 | |
Dr. John Yohan Kim, M.D. Allergy & Immunology Medicare: Accepting Medicare Assignments Practice Location: 103 Old Marlton Pike, Suite 211, Medford, NJ 08055 Phone: 856-576-5742 Fax: 856-519-5457 |