Provider Demographics
NPI:1376559708
Name:NAFTULIN, RICHARD J (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:NAFTULIN
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:P.O. BOX 8285
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-0285
Mailing Address - Country:US
Mailing Address - Phone:856-662-2400
Mailing Address - Fax:856-662-5525
Practice Address - Street 1:RT 38 &HADDONFIELD RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-0285
Practice Address - Country:US
Practice Address - Phone:856-662-2400
Practice Address - Fax:856-662-5525
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB 30477207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2461404Medicaid
NJE6104Medicare UPIN
NJ2461404Medicaid