Provider Demographics
NPI:1184667693
Name:SOUCIER, RONALD J (DO)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:J
Last Name:SOUCIER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 E SEABRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08226-4505
Mailing Address - Country:US
Mailing Address - Phone:609-289-2429
Mailing Address - Fax:
Practice Address - Street 1:2500 ENGLISH CREEK AVE
Practice Address - Street 2:BUILDING 200, SUITE 214
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-5549
Practice Address - Country:US
Practice Address - Phone:609-909-0200
Practice Address - Fax:609-909-0267
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB04430100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE70413Medicare UPIN
NJ4552903Medicare ID - Type Unspecified