Provider Demographics
NPI:1073577920
Name:CRUDELE, JAMES E (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:CRUDELE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:402 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:285 S CHURCH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-2773
Practice Address - Country:US
Practice Address - Phone:856-235-6116
Practice Address - Fax:856-235-7329
Is Sole Proprietor?:No
Enumeration Date:2006-04-15
Last Update Date:2011-05-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05091700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
702291SK3Medicare PIN
077356 SK3Medicare PIN