Provider Demographics
NPI:1003071010
Name:RADCLIFF, KRISTEN E (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:E
Last Name:RADCLIFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 NEW RD STE 3
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2106
Mailing Address - Country:US
Mailing Address - Phone:609-800-3472
Mailing Address - Fax:
Practice Address - Street 1:415 NEW RD STE 3
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2106
Practice Address - Country:US
Practice Address - Phone:609-800-3472
Practice Address - Fax:609-800-3472
Is Sole Proprietor?:No
Enumeration Date:2008-07-20
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08665500207X00000X, 207XS0117X
NY308177207X00000X
TXBP10016967207X00000X
PAMD437115207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery