| Rowansom Dept Of Family Practice | |
|
42 East Laurel Road Udp, Suite 2100 Stratford NJ 08084 | |
| (856) 566-7020 | |
| (856) 566-6188 |
| Full Name | Rowansom Dept Of Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 42 East Laurel Road, Stratford, New Jersey |
| Authorized Official Name and Position | Michael Rieker (INTERIM CHIEF FINANCIAL OFFICIER) |
| Authorized Official Contact | 8567705729 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rowansom Dept Of Family Practice Po Box 635 Bellmawr NJ 08099-0635 Ph: (856) 566-6706 | Rowansom Dept Of Family Practice 42 East Laurel Road Udp, Suite 2100 Stratford NJ 08084 Ph: (856) 566-7020 |
| NPI Number | 1790765055 |
|---|---|
| Provider Enumeration Date | 01/20/2006 |
| Last Update Date | 05/15/2013 |
| Medicare PECOS PAC ID | 5092606442 |
|---|---|
| Medicare Enrollment ID | O20040324000004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790765055 | NPI | - | NPPES |
| 3215709 | Medicaid | NJ | |
| CA1750 | Other | NJ | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | John Anthon Laratta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336125574 PECOS PAC ID: 1951384247 Enrollment ID: I20040609000025 |
| Provider Name | Meagan W Vermeulen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255311627 PECOS PAC ID: 3072571892 Enrollment ID: I20041228000109 |
| Provider Name | Joshua Scott Coren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750361820 PECOS PAC ID: 4385613496 Enrollment ID: I20050602000046 |
| Provider Name | Adarsh Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003896523 PECOS PAC ID: 5991749996 Enrollment ID: I20050613000110 |
| Provider Name | Todd Schachter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295727121 PECOS PAC ID: 3072558170 Enrollment ID: I20050620000832 |
| Provider Name | Rebecca C. Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558391490 PECOS PAC ID: 8426074782 Enrollment ID: I20051017000755 |
| Provider Name | Robert E Hudrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972583060 PECOS PAC ID: 4587760400 Enrollment ID: I20070509000210 |
| Provider Name | Kathryn C Lambert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538149646 PECOS PAC ID: 3173621075 Enrollment ID: I20070530000465 |
| Provider Name | Samantha Mara Plasner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346241437 PECOS PAC ID: 6204861511 Enrollment ID: I20080401000557 |
| Provider Name | Richard G Olarsch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285608745 PECOS PAC ID: 4587708797 Enrollment ID: I20100225000244 |
| Provider Name | George J Scott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699755710 PECOS PAC ID: 0244365310 Enrollment ID: I20100315000256 |
| Provider Name | Danielle L Cooley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972701613 PECOS PAC ID: 1951593854 Enrollment ID: I20101011000780 |
| Provider Name | Aubrey M Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962692715 PECOS PAC ID: 2163617002 Enrollment ID: I20101117000589 |
| Provider Name | Alison M Mancuso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861699282 PECOS PAC ID: 7810185246 Enrollment ID: I20101229000085 |
| Provider Name | Jennifer Nicole Caudle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184821597 PECOS PAC ID: 5395804231 Enrollment ID: I20110919000456 |
| Provider Name | Tara M Pellegrino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043531247 PECOS PAC ID: 5991943334 Enrollment ID: I20130524000484 |
| Provider Name | Sophia S Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417186842 PECOS PAC ID: 4284873126 Enrollment ID: I20130625000466 |
| Provider Name | Nils V Brolis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821385774 PECOS PAC ID: 2163647769 Enrollment ID: I20140715000312 |
| Provider Name | Ashley M Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104223809 PECOS PAC ID: 9335465079 Enrollment ID: I20150224001130 |
| Provider Name | Philip Blase Collins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073945135 PECOS PAC ID: 9931499274 Enrollment ID: I20160527001401 |
| Provider Name | Alexander Kowalski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932512357 PECOS PAC ID: 8325315914 Enrollment ID: I20170602000773 |
| Provider Name | Jennifer C Sepede |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225441405 PECOS PAC ID: 7315214715 Enrollment ID: I20170606000275 |
| Provider Name | Dianna M Shinkarow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033603949 PECOS PAC ID: 8022360379 Enrollment ID: I20181015001793 |
| Provider Name | Kanad Mukherjee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902273857 PECOS PAC ID: 6103113543 Enrollment ID: I20210107000021 |
| Provider Name | Anne Celal Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528222155 PECOS PAC ID: 5597917161 Enrollment ID: I20210830000076 |
Destyoncall Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 321 Yale Ave, Suite D, Stratford, NJ 08084 Phone: 856-627-6101 Fax: 856-627-6103 | |
Kennedy Medical Group Practice, P.c. D/b/a Kennedy Health Alliance Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 25 E Laurel Rd, Stratford, NJ 08084 Phone: 856-783-2244 Fax: 856-783-8537 | |
Rowansom Nmi Headache Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 42 E Laurel Rd, Udp #1700, Stratford, NJ 08084 Phone: 856-566-7010 Fax: 856-566-6956 | |
Goldis Geriatrics P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 E Laurel Rd, Stratford, NJ 08084 Phone: 856-346-3469 Fax: 856-346-9456 | |
Kennedy Medical Group Practice, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 E Laurel Rd, 1st Floor, Stratford, NJ 08084 Phone: 856-783-0870 Fax: 856-783-0649 | |
Kennedy Medical Group Practice, P.c. D/b/a Kennedy Health Alliance Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 E Laurel Rd, 2nd Floor, Stratford, NJ 08084 Phone: 856-783-1987 | |
Rowansom Dept Of Infectious Disease Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 42 E Laurel Rd Ste 3100, Stratford, NJ 08084 Phone: 856-566-7002 |