Provider Demographics
NPI:1164423406
Name:ARONOW, PHILLIP (MD)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:
Last Name:ARONOW
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 1:1 S CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:MERCHANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-2213
Mailing Address - Country:US
Mailing Address - Phone:856-663-4447
Mailing Address - Fax:856-488-6380
Practice Address - Street 1:1 S CENTRE ST
Practice Address - Street 2:
Practice Address - City:MERCHANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08109-2213
Practice Address - Country:US
Practice Address - Phone:856-663-4447
Practice Address - Fax:856-488-6380
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2024-03-16
Deactivation Date:2013-04-11
Deactivation Code:
Reactivation Date:2013-09-26
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02035300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ019309Medicare ID - Type Unspecified
NJ1548603Medicaid
C53855Medicare UPIN